| The risk of hemorrhage among patients with warfarin-associated coagulopathy. | |
| | |
MedLine Citation:
|
PMID: 16487849 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVES: Among warfarin-treated patients with international normalized ratio (INR) >5, we sought to determine the risk of major bleeding within 30 days. BACKGROUND: For warfarin-treated patients, the risk of bleeding increases as the INR rises, particularly if the INR exceeds 4. The 30-day risk of hemorrhage among outpatients with excessively prolonged INR values is unknown. METHODS: To assess anticoagulation care in the U.S., a cohort of 6,761 patients taking warfarin was prospectively assembled from 101 participating sites (43% were community-based cardiology practices). From this cohort, 1,104 patients were identified with a first episode of INR >5. RESULTS: A total of 979 met eligibility criteria; complete follow-up information was available for 976 (99.7%). Ninety-six percent (n = 937) of patients had an INR value between 5 and 9; 80% of INR values were <7. Thirteen patients (1.3%) experienced major hemorrhage during the 30-day follow-up period; among patients whose INR was >5 and <9, 0.96% experienced major hemorrhage. None of the bleeding events was fatal. Intervention with vitamin K was uncommon (8.7%). Warfarin doses were withheld for the majority of patients. Fifty percent of patients who were managed conservatively and retested on day 4 or 5 had an INR of 2.0 or less. CONCLUSIONS: For warfarin-treated outpatients presenting with an INR >5 and <9, the 30-day risk of major bleeding is low (0.96%). Intervention with vitamin K among asymptomatic patients presenting with an INR <9 is not routine practice in the U.S. |
| | |
Authors:
|
David A Garcia; Susan Regan; Mark Crowther; Elaine M Hylek |
Related Documents
:
|
7672549 - Prospective validation of the baylor bleeding score for predicting the likelihood of re... 7019959 - Intra-arterial tissue adhesive for medical splenectomy in humans. 8596849 - Azygos blood flow in cirrhosis: measurement with mr imaging and correlation with varice... 14992889 - Clinical significance of pla polymorphism of platelet gp iib/iiia receptors during long... 16510029 - Pharmacologic therapy for gastrointestinal bleeding due to portal hypertension and esop... 9638459 - Intraoperative enteroscopy in obscure gastrointestinal hemorrhage. 443909 - Kma-greenfield filter placement for chronic pulmonary hypertension. 12945719 - Therapy with statins in patients with refractory rheumatic diseases: a preliminary study. 2239189 - Internal fixation of tibial plateau fractures using the ao instrumentation. |
Publication Detail:
|
Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2006-01-26 |
Journal Detail:
|
Title: Journal of the American College of Cardiology Volume: 47 ISSN: 1558-3597 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 2006 Feb |
Date Detail:
|
Created Date: 2006-02-20 Completed Date: 2006-04-28 Revised Date: 2006-11-15 |
Medline Journal Info:
|
Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: United States |
Other Details:
|
Languages: eng Pagination: 804-8 Citation Subset: AIM; IM |
Affiliation:
|
Department of Medicine, University of New Mexico, Albuquerque, New Mexico, USA. davgarcia@salud.unm.edu |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Aged Anticoagulants / adverse effects* Female Hemorrhage / chemically induced*, prevention & control Humans International Normalized Ratio Male Middle Aged Risk Vitamin K / therapeutic use Warfarin / adverse effects* |
| Chemical | |
Reg. No./Substance:
|
0/Anticoagulants; 12001-79-5/Vitamin K; 81-81-2/Warfarin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Relationship of pulmonary arterial capacitance and mortality in idiopathic pulmonary arterial hypert...
Next Document: A comparison of the clinical impact of bleeding measured by two different classifications among pati...