Journals / Turkish Journal of Hematology / 2016 / Cilt: 33 - Sayı: 4

Hiperkoagülabilite Durumları Olan Hastalarda Terapötik Uluslararası Düzeltme Oranına Ulaşmak için Gerekli Warfarin Doz ve Süresi

Warfarin Dosing and Time Required to Reach Therapeutic International Normalized Ratio in Patients with Hypercoagulable Conditions

Pages
299–303
DOI
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⚡ TL;DR(Too Long; Didn't Read)

Conclusion: Patients with hypercoagulable conditions require approximately 10 mg of additional total warfarin dose and also require, on average, 2 extra days to reach therapeutic INR as compared to controls.

📌 3 Key Takeaways

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Objective & Hypothesis:Objective: The purpose of this study was to analyze the difference in duration of anticoagulation and dose of warfarin required to reach a therapeutic international normalized ratio [(INR) of 2 to 3] in patients with hypercoagulable conditions as compared to controls.
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Key Findings & Data:The total study population was 622.
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Conclusion & Impact:Conclusion: Patients with hypercoagulable conditions require approximately 10 mg of additional total warfarin dose and also require, on average, 2 extra days to reach therapeutic INR as compared to controls.
🔬Design:Review & Systematic Survey
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Abstract

Objective: The purpose of this study was to analyze the difference in duration of anticoagulation and dose of warfarin required to reach a therapeutic international normalized ratio [(INR) of 2 to 3] in patients with hypercoagulable conditions as compared to controls. To our knowledge, this study is the first in the literature to delineate such a difference. Materials and Methods: A retrospective chart review was performed in a tertiary care hospital. The total study population was 622. Cases (n=125) were patients with a diagnosis of a hypercoagulable syndrome who developed venous thromboembolism. Controls (n=497) were patients with a diagnosis of venous thromboembolism in the absence of a hypercoagulable syndrome and were matched for age, sex, and race. Results: The total dose of warfarin required to reach therapeutic INR in cases was higher (50.7±17.6 mg) as compared to controls (41.2±17.7 mg). The total number of days required to reach therapeutic INR in cases was 8.9±3.5 days as compared to controls (6.8±2.9 days). Both of these differences were statistically significant (p<0.001). Conclusion: Patients with hypercoagulable conditions require approximately 10 mg of additional total warfarin dose and also require, on average, 2 extra days to reach therapeutic INR as compared to controls.

Özet

Amaç: Bu çalışmanın amacı kontrollerle karşılaştırıldığında hiperkoagülabilite durumları olan hastalarda terapötik uluslararası düzeltme oranında (INR) 2 ile 3 aralığına ulaşmak için gerekli warfarin doz ve antikoagülan süresindeki farklılığı analiz etmektir. Bildiğimiz kadarıyla; bu farklılığı tarifleyen literatürdeki ilk çalışmadır. Gereç ve Yöntemler: Retrospektif dosya taraması 3. basamak hastanede yapıldı. Toplam çalışmaya alınan hasta sayısı 622 idi. Venöz tromboembolizmi olan bu hastalardan 125'inin hiperkoagülabilite sendromu olup yaş, cins ve etnik kökeni aynı 497 kontrol hastasında hiperkoagülabilite sendromu yoktu. Bulgular: Hastalarda terapötik INR'ye ulaşmak için gerekli total warfarin dozu (50,7±17,6 mg) kontrollerin dozu (41,2±17,7 mg) ile karşılaştırıldığında yüksekti. Terapötik INR'ye ulaşmak için gerekli total gün sayısı hastalarda 8,9±3,5 gün olup kontrollerde 6,8±2,9 gün idi. Her iki karşılaştırmada da istatistiksel farklılık anlamlı bulundu (p<0,001).Sonuç: Hiperkoagülabilite durumları olan hastalarda terapötik INR'ye ulaşmak için kontrollere göre yaklaşık 10 mg ek total warfarin dozu ve ortalama 2 ek gün gereklidir.

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Cite This Article

KAHLON, P., NABİ, S., ARSHAD, A., JABBAR, A., HAYTHEM, A. (2016). Hiperkoagülabilite Durumları Olan Hastalarda Terapötik Uluslararası Düzeltme Oranına Ulaşmak için Gerekli Warfarin Doz ve Süresi. Turkish Journal of Hematology, Cilt: 33 - Sayı: 4, 299–303. https://ajindex.com/articles/412788

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References (12)

  1. Varga EA, Kujovich JL. Management of inherited thrombophilia: guide for genetics professionals. Clin Genet 2012;81:7-17.
  2. EINSTEIN Investigators, Bauersachs R, Berkowitz SD, Brenner B, Buller HR, Decousus H, Gallus AS, Lensing AW, Misselwitz F, Prins MH, Raskob GE, Segers A, Verhamme P, Wells P, Agnelli G, Bounameaux H, Cohen A, Davidson BL, Piovella F, Schellong S. Oral rivaroxaban for symptomatic venous thromboembolism. N Engl J Med 2010;363:2499-2510.
  3. Crowther MA, Ginsberg JS, Julian J, Denburg J, Hirsh J, Douketis J, Laskin C, Fortin P, Anderson D, Kearon C, Clarke A, Geerts W, Forgie M, Green D, Costantini L, Yacura W, Wilson S, Gent M, Kovacs MJ. A comparison of two intensities of warfarin for the prevention of recurrent thrombosis in patients with the antiphospholipid antibody syndrome. N Engl J Med 2003;349:1133-1138. Johnson JA. Warfarin pharmacogenetics: a rising tide for its clinical value. Circulation 2012;125:1964-1966.
  4. Holbrook AM, Pereira JA, Labiris R, McDonald H, Douketis JD, Crowther M, Wells PS. Systematic overview of warfarin and its drug and food interactions. Arch Intern Med 2005;165:1095-1106.
  5. Whitlon DS, Sadowski JA, Suttie JW. Mechanism of coumarin action: significance of vitamin K epoxide reductase inhibition. Biochemistry 1978;17:1371-1377.
  6. Guyatt GH, Akl EA, Crowther M, Gutterman DD, Schuünemann HJ; American college of chest physicians antithrombotic therapy and prevention of thrombosis panel. executive summary: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest 2012;141(Suppl 2):7-47.
  7. Zivelin A, Rao LV, Rapaport SI. Mechanism of the anticoagulant effect of warfarin as evaluated in rabbits by selective depression of individual procoagulant vitamin K-dependent clotting factors. J Clin Invest 1993;92:2131-2140.
  8. Weitz JI, Hudoba M, Massel D, Maraganore J, Hirsh J. Clot-bound thrombin is protected from inhibition by heparin-antithrombin III but is susceptible to inactivation by antithrombin III-independent inhibitors. J Clin Invest 1990;86:385-391.
  9. Wessler S, Gitel SN. Warfarin. From bedside to bench. N Engl J Med 1984;311:645-652.
  10. Kuruvilla M, Gurk-Turner C. A review of warfarin dosing and monitoring. Proc (Bayl Univ Med Cent) 2001;14:305-306.
  11. Harrison L, Johnston M, Massicotte MP, Crowther M, Moffat K, Hirsh J. Comparison of 5-mg and 10-mg loading doses in initiation of warfarin therapy. Ann Intern Med 1997;126:133-136.
  12. Kovacs MJ, Rodg