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[Long term oral anticoagulation: indications and problems].

There are several well established indications for long term oral anticoagulation, including atrial fibrillation, valvular heart disease and some categories of venous thromboembolic disease. Bleeding is the major complication. Apart from the estimated benefits and risks of long term oral anticoagulation in an individual patient, many practical issues interfering with the management of such treatment should be taken into account. These include compliance, factors causing high INR variability and necessity of frequent monitoring. Involving patients in the decision and treatment management highly improves efficacy and security of long term oral anticoagulation.