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Oral vitamin K effectively treats international normalised ratio (INR) values in excess of 10

Journal: Thrombosis and Haemostasis
ISSN: 0340-6245
Topic:

Stem cells in cardiovascular biology and medicine

DOI: http://dx.doi.org/10.1160/TH09-12-0822
Issue: 2010: 104/1 (July) pp. 1-190
Pages: 118-121

Oral vitamin K effectively treats international normalised ratio (INR) values in excess of 10

Results of a prospective cohort study

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

Keywords

thrombosis, Haemostasis, oral anticoagulants, acquired coagulation disorders

Summary

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.

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