High-risk Anticoagulation Patients: A Conversation with Oussama Wazni, MD, and Walid Saliba, MD

Co-Directors of Cleveland Clinic’s High-risk Anticoagulation Clinic, Oussama Wazni, MD, and Walid Saliba, MD, explain the proper approach to treating patients resistant to traditional anticoagulant medications.

Whom should PCPs refer to the High-risk Anticoagulation Clinic?

Any patients who have atrial fibrillation with a history of bleeding (whether in the stomach, intestines or brain) who cannot take traditional anticoagulant medications are appropriate to refer to our clinic. Effectively reducing their stroke risk is still possible.

Why is a multidisciplinary approach key for this patient population?

Today, new medications and procedures are available to help patients who cannot take traditional anticoagulants.

Cleveland Clinic’s Sydell and Arnold Miller Family Heart & Vascular Institute has combined specialists in electrophysiology, vascular medicine, gastroenterology and neurovascular medicine to provide a multidisciplinary approach to reducing stroke risk. Our High-risk Anticoagulation Clinic team will work together with your patients to assess their risk of stroke and bleeding and create an individualized care plan that best meets their needs.

In addition to the electrophysiology specialists, our team includes John Bartholomew, MD (Vascular Medicine); Sunguk Jang, MD, and Chung-Jyi Tsai, MD, PhD (Gastroenterology and Hepatology); and Muhammad Shazam Hussain, MD (Neurovascular Medicine).

What can patients expect?

Based on their medical history, patients will have specialized blood work and imaging tests (electrocardiogram, comprehensive transthoracic echo, transesophageal echo, cardiac MR and multidetector CT scanning, EGD).

They will meet with a cardiologist from the High-risk Anticoagulation Clinic, who will review their records and medical history, perform a physical examination, review their test results, and provide them with an assessment and plan. If patients need to meet with one of the other multidisciplinary specialists, they will be consulted in one to two days.

You can refer patients to the High-risk Anticoagulation Clinic by calling 216.444.0400.