Randomized Trial of Warfarin Nomograms
Authors: Michael J. Kovacs, Philip S. Wells
Journal: Annals of Internal Medicine (2004)

Letters16 March 2004Randomized Trial of Warfarin NomogramsMichael J. Kovacs, MD, FRCPC and Philip S. Wells, MD, FRCPC, MScMichael J. Kovacs, MD, FRCPCFrom London Health Sciences Centre, London, Ontario N6A 4G5, Canada, and Ottawa Hospital—Civic Campus; Ottawa, Ontario K1Y 4E9, Canada.Search for more papers by this author and Philip S. Wells, MD, FRCPC, MScFrom London Health Sciences Centre, London, Ontario N6A 4G5, Canada, and Ottawa Hospital—Civic Campus; Ottawa, Ontario K1Y 4E9, Canada.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-140-6-200403160-00030 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We thank all of the correspondents for the interest in our article, which has initiated a strong and emotional debate. Given the strong shift, however, of treatment of acute thromboembolism to an outpatient setting using low-molecular-weight heparin, it is imperative to have a simple means to achieve therapeutic oral anticoagulation in an efficient, timely, and predictable fashion.Much press has been given to the fact that the INR may predominantly reflect factor VII levels during initiation of oral anticoagulant therapy, but with concomitant primary therapy (that is, therapy with low-molecular-weight heparin), no clinical consequences have been reported. Perhaps ...References1. Warkentin TE, Levine MN, Hirsh J, Horsewood P, Roberts RS, Gent M, et al . Heparin-induced thrombocytopenia in patients treated with low-molecular-weight heparin or unfractionated heparin. N Engl J Med. 1995;332:1330-5. [PMID: 7715641] CrossrefMedlineGoogle Scholar2. Warkentin TE, Elavathil LJ, Hayward CP, Johnston MA, Russett JI, Kelton JG. The pathogenesis of venous limb gangrene associated with heparin-induced thrombocytopenia. Ann Intern Med. 1997;127:804-12. [PMID: 9382401] LinkGoogle Scholar Author, Article, and Disclosure InformationAuthors: Michael J. Kovacs, MD, FRCPC; Philip S. Wells, MD, FRCPC, MScAffiliations: From London Health Sciences Centre, London, Ontario N6A 4G5, Canada, and Ottawa Hospital—Civic Campus; Ottawa, Ontario K1Y 4E9, Canada. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoThe Pathogenesis of Venous Limb Gangrene Associated with Heparin-Induced Thrombocytopenia Theodore E. Warkentin , Leela J. Elavathil , Catherine P.M. Hayward , Marilyn A. Johnston , Jean I. Russett , and John G. Kelton Comparison of 10-mg and 5-mg Warfarin Initiation Nomograms Together with Low-Molecular-Weight Heparin for Outpatient Treatment of Acute Venous Thromboembolism Michael J. Kovacs , Marc Rodger , David R. Anderson , Beverly Morrow , Gertrude Kells , Judy Kovacs , Eleanor Boyle , and Philip S. Wells Randomized Trial of Warfarin Nomograms Gregory M. Peterson and Shane L. Jackson Randomized Trial of Warfarin Nomograms Richard White and William Dager Randomized Trial of Warfarin Nomograms Robert Zeller Randomized Trial of Warfarin Nomograms Brian F. Gage Randomized Trial of Warfarin Nomograms Robert J. DiDomenico Randomized Trial of Warfarin Nomograms Mark A. Crowther , Linda Harrison , and Jack Hirsh Randomized Trial of Warfarin Nomograms Theodore E. Warkentin Randomized Trial of Warfarin Nomograms Kenneth L. McCall Metrics 16 March 2004Volume 140, Issue 6Page: 491-492KeywordsAnticoagulant therapyHeparinHeparin-induced thrombocytopeniaInternational normalized ratioLow molecular weight heparinOutpatientsRandomized trialsSafetyThromboembolismVenous thromboembolism ePublished: 16 March 2004 Issue Published: 16 March 2004 Copyright & PermissionsCopyright © 2004 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...