Death and defeat: Joseph Stalin suffered atherosclerosis due to his heavy smoking. Early morning on March 1 Stalin went to bed. At dawn Stalin did not leave his bedroom. His guards found it unusual that Stalin didn't wake up at his usual time. They were under orders to not disturb Stalin and left him alone for the rest of the day.
In patients with previous arterial embolism, only 4 daily doses of warfarin should be withheld preoperatively and the INR should be measured the day before surgery to determine if a small dose of vitamin K is needed to accelerate the reversal of anticoagulation.
Why would a patient be given heparin and warfarin at the same time. Heparin is faster acting, as Warfarin takes a couple of days to act. Initially, you will be given heparin and warfarin together until your INR is in range. Warfarin usually takes a couple of days to reach the correct level, so you need the heparin to help treat the clot while the warfarin starts to act.