What is a contraindication to anticoagulation therapy?

Inability to maintain therapeutic range with medications is a significant contraindication to anticoagulation therapy because effective anticoagulation requires precise management of drug levels to prevent both thromboembolic events and bleeding complications. When a patient cannot maintain the therapeutic range, it poses a risk of either under-treatment, leading to clots, or over-treatment, which can result in severe bleeding. This instability in maintaining the necessary levels makes anticoagulation not only ineffective but also dangerous, hence necessitating consideration for alternative therapies, such as Left Atrial Appendage Occlusion, to mitigate associated risks.

While other options may pose challenges, they do not universally contraindicate anticoagulation therapy. For example, advanced age might require careful monitoring but does not inherently prevent therapy. Similarly, having a history of successful surgery or engaging in high levels of physical activity does not exclude a patient from being a candidate for anticoagulation. It is the inability to manage medication levels effectively that fundamentally disrupts the safety and efficacy of anticoagulation therapy, making it a critical contraindication.