My dad, age 83 was hospitalized for a severe LGI bleed due to a mildly supra-therapeutic INR (~3.2) on a background of pancolonic diverticulosis. Although the bleeding had spontaneously stopped, it was believed he had a sentinal bleed of a colonic origin. His Hg dropped to about 58 and fortunately he did not suffer a second MI. He was ressucitated, and had an admission GI workup, as well as echo (showing MR, severe TR, mild aortic
friends have suggested he only go back on a baby aspirin a day and d/c coumadin. Their reasoning is that the much lower risk of bleeding with aspirin, while accepting a slightly higher risk or a stroke is better than using coumadin with a much higher risk of bleeding and a slighly better risk of stroke prevention.
I would very much like to have some guidance as to which way the evidence leans.