Medline ® Abstract for Reference 68
of 'Management of warfarin-associated bleeding or supratherapeutic INR'
68
TI
Reversal of excessive oral anticoagulation with a low oral dose of vitamin K1 compared with acenocoumarine discontinuation. A prospective, randomized, open study.
AU
Fondevila CG, Grosso SH, Santarelli MT, Pinto MD
SO
Blood Coagul Fibrinolysis. 2001;12(1):9.
We performed a prospective, randomized, open study in 109 outpatients under chronic anticoagulation with acenocoumarine, presenting with International Normalized Ratios (INRs)>or = 6.0 and no or minor bleeding. All the patients withheld one dose of acenocoumarine; in addition, a treated group also received 1 mg oral vitamin K1. We aimed at a post-intervention INR<6.0, with a target zone of 2.0-4.0. The INRs were lowered from a mean of 8.1 +/- 1.7 to 4.9 +/- 2.5 in the controls (P = 0.0000) and from 8.4 +/- 2.4 to 3.3 +/- 3 in the treated patients (P = 0.0000). There were no differences in the percentage of patients with post-intervention INRs<6.0 or within the therapeutic zone. One-third of the treated patients and only 2% of the controls reached INRs<2.0 (P = 0.0003). Oral vitamin K1 offered no advantage to the simple discontinuation of one dose of acenocoumarine. A substantial number of treated patients were consequently exposed to under-anticoagulation.
AD
Hemostasis and Thrombosis Department, Instituto de Investigaciones Hematológicas M. Castex, Academia Nacional de Medicina, Buenos Aires, Argentina.
PMID