Anti-coagulate or not becomes a choice of risk it seems. I am at a loss to know how a doctor can advise definitively on what is the best or least risky choice especially if a patient is taking multiple drugs and/or supplements. It seems doctor's recommendations are based on their knowledge of the studies they happened to have read to date, what drug companies say, and their knowledge of the patient's present health situation. Their decisions are influenced by what they can remember; and, in some countries, by their liability insurance coverage. Anybody play roulette? It seems doctors do and patient's lives are their chips.
I just read an article on thalidomide babies in the Saturday Toronto Globe and Mail paper so maybe I feel a bit jaded. The US did not approve this medication thanks to the efforts of a Canadian who stood up to the FDA. Yet, Canada, which allowed the drug to be sold the longest, has done the least to help these people. One mother said she took only one pill and her baby was born deformed. Unfortunately, this is not the only case where drugs have been found to cause disastrous consequences.
The website below is a summary of yet another study.