Randomized Trial of Warfarin Nomograms
Authors: Theodore E. Warkentin
Journal: Annals of Internal Medicine (2004)

Letters16 March 2004Randomized Trial of Warfarin NomogramsTheodore E. Warkentin, MDTheodore E. Warkentin, MDFrom Hamilton General Hospital, Hamilton, Ontario L8L 2X2, Canada.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-140-6-200403160-00028 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:In their randomized, double-blind trial, Kovacs and colleagues (1) concluded that loading doses of warfarin (10 mg on 2 consecutive days) are more effective than standard dosing (5 mg on 2 consecutive days) in achieving therapeutic INR values among outpatients with deep venous thrombosis who were receiving at least 5 days of therapy with low-molecular-weight heparin. However, the authors have not adequately established the safety of this approach, particularly with respect to avoiding prothrombotic complications of warfarin. Among their study's end points, the authors did not list 2 such sequelae: warfarin-induced skin necrosis and warfarin-induced venous limb ...References1. Kovacs MJ, Rodger M, Anderson DR, Morrow B, Kells G, Kovacs J, et al . Comparison of 10-mg and 5-mg warfarin initiation nomograms together with low-molecular-weight heparin for outpatient treatment of acute venous thromboembolism. A randomized, double-blind, controlled trial. Ann Intern Med. 2003;138:714-9. [PMID: 12729425] LinkGoogle Scholar2. Warkentin TE. Thrombotic complications of anticoagulant therapy.. In: Colman RW, Hirsh J, Marder VJ, Clowes AW, George JN, eds. Hemostasis and Thrombosis. Basic Principles and Clinical Practice. 4th ed. Philadelphia: Lippincott Williams & Wilkins; 2000:1371-82. Google Scholar3. 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 Scholar4. Physicians' Desk Reference. 56th ed. Montvale, NJ: Medical Economics; 2002:1247. Google Scholar Author, Article, and Disclosure InformationAuthors: Theodore E. Warkentin, MDAffiliations: From Hamilton General Hospital, Hamilton, Ontario L8L 2X2, 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 Kenneth L. McCall Randomized Trial of Warfarin Nomograms Michael J. Kovacs 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 Metrics Cited byA 10 mg warfarin initiation nomogram is safe and effective in outpatients starting oral anticoagulant therapy for venous thromboembolism 16 March 2004Volume 140, Issue 6Page: 490-491KeywordsHeparin-induced thrombocytopeniaInternational normalized ratioLow molecular weight heparinMedical risk factorsNecrosisOutpatientsProtein C deficiencyProtein S deficiencyRandomized trialsSafety ePublished: 16 March 2004 Issue Published: 16 March 2004 Copyright & PermissionsCopyright © 2004 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...