Vitamin K to Correct Overanticoagulation
Authors: Ayad Jindeel
Journal: Annals of Internal Medicine (2009)

Letters15 September 2009Vitamin K to Correct OveranticoagulationAyad Jindeel, MDAyad Jindeel, MDFrom Harbor-UCLA Medical Center, Torrance, CA 90509.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-151-6-200909150-00019 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Crowther and colleagues (1) raise an important management question regarding a common clinical problem: What do we do with patients who are not bleeding but who have prolonged INR between 4.5 and 10.0 while taking warfarin?Although the study showed administering oral vitamin K, 1.25 mg, to be statistically significantly more effective in decreasing INR to the therapeutic range than just withholding 1 dose of warfarin, the conclusion was that “[l]ow-dose oral vitamin K did not reduce bleeding in warfarin recipients with INRs of 4.5 to 10.0.” Thirty-four patients (10.1%) in the placebo group versus 136 patients ...References1. Crowther MA, Ageno W, Garcia D, Wang L, Witt DM, Clark NP, et al. Oral vitamin K versus placebo to correct excessive anticoagulation in patients receiving warfarin: a randomized trial. Ann Intern Med. 2009;150:293-300. [PMID: 19258557] LinkGoogle Scholar2. Hylek EM, Chang YC, Skates SJ, Hughes RA, Singer DE. Prospective study of the outcomes of ambulatory patients with excessive warfarin anticoagulation. Arch Intern Med. 2000;160:1612-7. [PMID: 10847254] CrossrefMedlineGoogle Scholar3. Ansell J, Hirsh J, Hylek E, Jacobson A, Crowther M, Palareti G; American College of Chest Physicians. Pharmacology and management of the vitamin K antagonists: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest. 2008;133:160S-198S. [PMID: 18574265] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Harbor-UCLA Medical Center, Torrance, CA 90509.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoOral Vitamin K Versus Placebo to Correct Excessive Anticoagulation in Patients Receiving Warfarin Mark A. Crowther , Walter Ageno , David Garcia , Luqi Wang , Dan M. Witt , Nathan P. Clark , Mark D. Blostein , Susan R. Kahn , Sara K. Vesely , Sam Schulman , Michael J. Kovacs , Marc A. Rodger , Phillip Wells , David Anderson , Jeffery Ginsberg , Rita Selby , Sergio Siragusa , Mauro Silingardi , Mary Beth Dowd , and Clive Kearon Vitamin K to Correct Overanticoagulation P. Dileep Kumar Vitamin K to Correct Overanticoagulation Mark A. Crowther and David Garcia Vitamin K to Correct Overanticoagulation Mark W. Swaim and B. Gail Macik Vitamin K to Correct Overanticoagulation Vittorio Pengo , Gentian Denas , and Seena Padayattil Jose Vitamin K to Correct Overanticoagulation Robert C. Pendleton and Sara Vazquez Metrics 15 September 2009Volume 151, Issue 6Page: 434KeywordsConflicts of interestHemorrhageHospitalizationsInternational normalized ratioThoraxVitamin K ePublished: 15 September 2009 Issue Published: 15 September 2009 Copyright & PermissionsCopyright © 2009 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...