Warfarin remains one of the most widely used anticoagulants worldwide, despite the growth of DOACs. Its clinical relevance persists for patients with mechanical heart valves, atrial fibrillation, venous thromboembolism and hypercoagulable states. Because of its narrow therapeutic window, complex interactions and need for structured INR monitoring, clinicians continue to seek evidence-updated insights on Warfarin during pharmacology and anticoagulation tracks at a cardiology conference. This session offers an in-depth examination of advanced anticoagulation-management strategies, highlighting essential principles for safe and effective therapy.

The session begins by exploring Warfarin’s mechanism of action, reviewing its effects on vitamin-K–dependent clotting factors and protein C/S pathways. Participants learn how genetics, hepatic metabolism, diet, medications, comorbidities and lifestyle factors influence dose variability. Detailed discussion addresses patient groups where Warfarin remains the preferred therapy, including mechanical-valve recipients, severe renal-impairment patients, antiphospholipid-syndrome cases and pregnancy-specific indications where DOACs are contraindicated.

Therapeutic management emphasises INR targets, dose-adjustment protocols, loading strategies, bridging plans and long-term monitoring. Attendees review structured approaches for initiation, stabilisation and maintenance therapy. The session highlights how point-of-care INR testing, home monitoring, counselling and workflow integration improve adherence and reduce complications.

Safety considerations include bleeding-risk assessment, reversal protocols, use of vitamin K, prothrombin complex concentrate, fresh-frozen plasma and hospital pathways for urgent correction. Participants also examine interactions with antibiotics, antifungals, antiepileptics, herbal supplements and dietary vitamin K fluctuations.

Comparative considerations evaluate Warfarin versus DOACs, including cost, reversibility, patient suitability and long-term outcomes. Attendees also explore perioperative management, cardioversion planning, pregnancy anticoagulation and integration with antiplatelet pathways.

Future perspectives highlight pharmacogenomic-guided dosing, digital-therapeutic platforms, algorithmic INR prediction and remote-monitoring systems transforming the safety and efficiency of Warfarin therapy.