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Article: Comparison of the efficacy and safety profiles of intravenous vitamin K and fresh frozen plasma as treatment of warfarin-related over-anticoagulation in patients with mechanical heart valves

TitleComparison of the efficacy and safety profiles of intravenous vitamin K and fresh frozen plasma as treatment of warfarin-related over-anticoagulation in patients with mechanical heart valves
Authors
Issue Date2006
PublisherExcerpta Medica, Inc.. The Journal's web site is located at http://www.ajconline.org/
Citation
American Journal Of Cardiology, 2006, v. 97 n. 3, p. 409-411 How to Cite?
AbstractPatients on warfarin for mechanical heart valves are at increased risk for thromboembolic events and intracranial hemmorhage. In current guidelines, a low dose of vitamin K is the recommended treatment for moderate over-anticoagulation based on studies in which only minority patients participating had mechanical heart valves.We performed a randomized controlled trial to compare the efficacy and safety profile of low-dose intravenous vitamin K and fresh frozen plasma (FFP) for patients with mechanical heart valves and mild to moderate over-anticoagulation (international normalized ratio [INR] 4 to 7). In a 24-month period, we randomized 102 patients to (1) vitamin K or (2) FFP. The baseline INR at presentation between the vitamin K group and the FFP group was 4.61 ± 0.007 vs 4.78 ± 0.07 (p = 0.11). Six hours after treatment, patients in the FFP group had a signficantly lower mean INR compared with the vitamin K group (2.75 ± 0.06 vs 3.44 ± 0.10, p = 0.01). No patient in both groups had over-correction (INR <2). One week later, there was no significant difference in mean INR between both groups (2.7 ± 0.11 vs 2.56 ± 0.12, p = 0.41). Fifty-eight percent of patients in the FFP group and 51% in the vitamin K group had an INR within the target range. There were no adverse reactions or outcomes in both groups. In conclusion, intravenous low-dose vitamin K is a safe alternative to FFP infusion for warfarin overdose in patients with mechanical heart valves. © 2006 Elsevier Inc. All rights reserved.
Persistent Identifierhttp://hdl.handle.net/10722/134147
ISSN
2015 Impact Factor: 3.154
2015 SCImago Journal Rankings: 2.063
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorYiu, KHen_HK
dc.contributor.authorSiu, CWen_HK
dc.contributor.authorJim, MHen_HK
dc.contributor.authorTse, HFen_HK
dc.contributor.authorFan, Ken_HK
dc.contributor.authorChau, MCen_HK
dc.contributor.authorChow, WHen_HK
dc.date.accessioned2011-06-13T07:20:13Z-
dc.date.available2011-06-13T07:20:13Z-
dc.date.issued2006en_HK
dc.identifier.citationAmerican Journal Of Cardiology, 2006, v. 97 n. 3, p. 409-411en_HK
dc.identifier.issn0002-9149en_HK
dc.identifier.urihttp://hdl.handle.net/10722/134147-
dc.description.abstractPatients on warfarin for mechanical heart valves are at increased risk for thromboembolic events and intracranial hemmorhage. In current guidelines, a low dose of vitamin K is the recommended treatment for moderate over-anticoagulation based on studies in which only minority patients participating had mechanical heart valves.We performed a randomized controlled trial to compare the efficacy and safety profile of low-dose intravenous vitamin K and fresh frozen plasma (FFP) for patients with mechanical heart valves and mild to moderate over-anticoagulation (international normalized ratio [INR] 4 to 7). In a 24-month period, we randomized 102 patients to (1) vitamin K or (2) FFP. The baseline INR at presentation between the vitamin K group and the FFP group was 4.61 ± 0.007 vs 4.78 ± 0.07 (p = 0.11). Six hours after treatment, patients in the FFP group had a signficantly lower mean INR compared with the vitamin K group (2.75 ± 0.06 vs 3.44 ± 0.10, p = 0.01). No patient in both groups had over-correction (INR <2). One week later, there was no significant difference in mean INR between both groups (2.7 ± 0.11 vs 2.56 ± 0.12, p = 0.41). Fifty-eight percent of patients in the FFP group and 51% in the vitamin K group had an INR within the target range. There were no adverse reactions or outcomes in both groups. In conclusion, intravenous low-dose vitamin K is a safe alternative to FFP infusion for warfarin overdose in patients with mechanical heart valves. © 2006 Elsevier Inc. All rights reserved.en_HK
dc.languageengen_US
dc.publisherExcerpta Medica, Inc.. The Journal's web site is located at http://www.ajconline.org/en_HK
dc.relation.ispartofAmerican Journal of Cardiologyen_HK
dc.subject.meshAnticoagulants - adverse effectsen_HK
dc.subject.meshBlood Coagulation Disorders - chemically induced - drug therapyen_HK
dc.subject.meshBlood Component Transfusionen_HK
dc.subject.meshCoagulants - administration & dosageen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshHeart Valve Diseases - surgeryen_HK
dc.subject.meshHeart Valve Prosthesisen_HK
dc.subject.meshHeart Valve Prosthesis Implantationen_HK
dc.subject.meshHumansen_HK
dc.subject.meshInfusions, Intravenousen_HK
dc.subject.meshInternational Normalized Ratioen_HK
dc.subject.meshMaleen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshPlasmaen_HK
dc.subject.meshProspective Studiesen_HK
dc.subject.meshTreatment Outcomeen_HK
dc.subject.meshVitamin K - administration & dosageen_HK
dc.subject.meshWarfarin - adverse effectsen_HK
dc.titleComparison of the efficacy and safety profiles of intravenous vitamin K and fresh frozen plasma as treatment of warfarin-related over-anticoagulation in patients with mechanical heart valvesen_HK
dc.typeArticleen_HK
dc.identifier.emailYiu, KH:khkyiu@hku.hken_HK
dc.identifier.emailSiu, CW:cwdsiu@hkucc.hku.hken_HK
dc.identifier.emailTse, HF:hftse@hkucc.hku.hken_HK
dc.identifier.authorityYiu, KH=rp01490en_HK
dc.identifier.authoritySiu, CW=rp00534en_HK
dc.identifier.authorityTse, HF=rp00428en_HK
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1016/j.amjcard.2005.08.062en_HK
dc.identifier.pmid16442406-
dc.identifier.scopuseid_2-s2.0-31144433768en_HK
dc.identifier.hkuros209848-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-31144433768&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume97en_HK
dc.identifier.issue3en_HK
dc.identifier.spage409en_HK
dc.identifier.epage411en_HK
dc.identifier.isiWOS:000235265400023-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridYiu, KH=35172267800en_HK
dc.identifier.scopusauthoridSiu, CW=7006550690en_HK
dc.identifier.scopusauthoridJim, MH=6603860344en_HK
dc.identifier.scopusauthoridTse, HF=7006070805en_HK
dc.identifier.scopusauthoridFan, K=7202978353en_HK
dc.identifier.scopusauthoridChau, MC=11839949900en_HK
dc.identifier.scopusauthoridChow, WH=7402281062en_HK

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