期刊
BRITISH JOURNAL OF HAEMATOLOGY
卷 132, 期 5, 页码 604-607出版社
BLACKWELL PUBLISHING
DOI: 10.1111/j.1365-2141.2005.05917.x
关键词
international normalised ratio (INR); warfarin; vitamin K-dependent factors; vitamin K therapy
类别
Patients with a supratherapeutic international normalised ratio (ST-INR) are at risk for bleeding. ST-INR is corrected by withholding warfarin therapy and often by supplementing vitamin K or providing vitamin K-dependent factors; the exact therapeutic decision is based on the extent of the prolonged INR. Currently, ST-INRs are frequently observed in clinical practice due to the use of sensitive recombinant tissue thromboplastin reagents and automation. However, there are scant data correlating an ST-INR with various vitamin K-dependent factors. This prospective cohort study, set in a large tertiary care teaching hospital for the University of Texas Southwestern Medical Center at Dallas, defined the relationship between ST-INR (> 5(.)0) and measured vitamin K-dependent procoagulant factors. Prothrombin time, INR and vitamin K-dependent factors II, VII, IX and X were measured in 78 patients with an INR > 5(.)0 (ST-INR) who were on warfarin therapy for more than 2 months. There was no significant relationship between the ST-INR and levels of important vitamin K-dependent factors II and X. These data support the recent guidelines that the management of an INR > 5(.)0 should be driven by the clinical determinants rather than specific INR values per se.
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