M. A. Crowther (1), D. Garcia (2), W. Ageno (3), L. Wang (1), D. M. Witt (4), N. P. Clark (4), M. D. Blostein (5), S. R. Kahn (5), S. Schulman (1), M. Kovacs (6), M. A. Rodger (7), P. Wells (7), D. Anderson (8), J. Ginsberg (1), R. Selby (9), S. Siragusa (10), M. Silingardi (11), M. B. Dowd (4), C. Kearon (1)
(1) Department of Medicine, McMaster University, Hamilton, Ontario, Canada; (2) Department of Medicine, University of New Mexico, Albuquerque, New Mexico, USA; (3) Department of Medicine, University of Insubria, Varese, Italy; (4) Clinical Pharmacy Anticoagulation Service, Kaiser Permanente Colorado, Denver, Colorado, USA; (5) Department of Medicine, McGill University, Montreal, Quebec, Canada; (6) Department of Medicine, University of Western Ontario, London, Ontario, Canada; (7) Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada; (8) Department of Medicine, Dalhousie, Halifax, Nova Scotia, Canada; (9) Department of Medicine, University of Toronto, Toronto, British Columbia, Canada; (10) Division of Hematology, University of Palermo, Palermo, Italy; (11) Department of Medicine, Reggio Emilia, Italy
Unanticipated elevation of the INR is common in patients receiving warfarin. We performed a prospective cohort study of 107 warfarin-treated patients with INR values of more than 10 who received a single 2.5 mg dose of oral vitamin K. During the first week, one patient experienced major bleeding, and one died. In the first 90 days after enrolment four patients had major bleeding (3.7%, 1.0% to 9.3%), eight patients (7.5%, 3.3% to 14.2%) died and two had objectively confirmed thromboembolism. Based on our low rate of observed major bleeding we conclude that 2.5 mg of oral vitamin K is a reasonable treatment for patients with INR values of more than 10 who are not actively bleeding.
thrombosis, Haemostasis, oral anticoagulants, acquired coagulation disorders
Thromb Haemost 2008 99 3: 466-472
A. J. Reininger
Hämostaseologie 2007 27 4: 247-250
Mohammad Urooj Zafar1, David A. Vorchheimer1, Juan Gaztanaga1, Mauricio Velez1, Daniel Yadegar1, Pedro R. Moreno1, Satoshi Kunitada2, Juan Pagan2, Valentin Fuster1, Juan J. Badimon1
Thromb Haemost 2007 98 4: 883-888
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