Document Detail


Unreliability of international normalized ratio for monitoring warfarin therapy in patients with lupus anticoagulant.
MedLine Citation:
PMID:  15303447     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
STUDY OBJECTIVE: To compare the international normalized ratios (INRs) of patients positive for lupus anticoagulant and the INRs of control patients receiving warfarin therapy with equivalent therapeutic chromogenic factor X levels. DESIGN: Prospective case series. SETTING: A 625-bed, adult, private, tertiary care teaching hospital. PATIENTS: Sixty-eight outpatients positive for lupus anticoagulant and 57 control patients receiving long-term warfarin therapy. MEASUREMENTS AND MAIN RESULTS: Concomitant INR and chromogenic factor X activity were measured in all patients. In 44 control patients (77%) and 46 patients with lupus anticoagulant (68%), chromogenic factor X activity was 22-40% of normal, which is therapeutic. Of the 44 control patients, 4 (9%) had an INR above 3.0, and none had an INR above 4.0. In contrast, 18 (39%) of the 46 patients with lupus anticoagulant had an INR above 3.0, and 5 (11%) had an INR above 4.0. CONCLUSION: At least 10% of patients with lupus anticoagulant receiving long-term warfarin therapy may have falsely high INR values, which could lead to inappropriate warfarin dosage reduction. Monitoring warfarin therapy by chromogenic factor X activity in patients with lupus anticoagulant avoids this INR artifact.
Authors:
Terry K Rosborough; Michele F Shepherd
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Pharmacotherapy     Volume:  24     ISSN:  0277-0008     ISO Abbreviation:  Pharmacotherapy     Publication Date:  2004 Jul 
Date Detail:
Created Date:  2004-08-11     Completed Date:  2004-11-04     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8111305     Medline TA:  Pharmacotherapy     Country:  United States    
Other Details:
Languages:  eng     Pagination:  838-42     Citation Subset:  IM    
Affiliation:
Medical Education Department, Abbott Northwestern Hospital, Minneapolis, Minnesota 55407, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Female
Humans
International Normalized Ratio / standards*
Lupus Coagulation Inhibitor / blood*
Male
Middle Aged
Prospective Studies
Reproducibility of Results
Statistics, Nonparametric
Warfarin / therapeutic use*
Chemical
Reg. No./Substance:
0/Lupus Coagulation Inhibitor; 81-81-2/Warfarin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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