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Journal of Thrombosis and Haemostasis

Journal of Thrombosis and Haemostasis

IF: 5.5
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Treatment of coumarin-associated coagulopathy: a systematic review and proposed treatment algorithms

Published:11 April 2006 DOI: 10.1111/j.1538-7836.2006.01986.x PMID: 16961594
F. DENTALI, W. AGENO, M. CROWTHER

Abstract

Summary. Background: An excessive anticoagulant effect because of coumarins is frequently encountered. Objective: To review available literature on the management of warfarin-associated coagulopathy and to propose evidence-based treatment algorithms. Methods: Data sources were Medline and Embase. Papers published between 1966 and December 2005 describing randomized trials or prospective cohort studies evaluating treatments for coumarin-associated coagulopathy were abstracted. Results: Low dose oral vitamin K rapidly and reliably returns the international normalized ratio (INR) to the usual therapeutic range in non-bleeding patients. Simple withholding of acenocumarol results in rapid correction of its anticoagulant effect. The impact of oral vitamin K on phenprocumon-associated coagulopathy cannot be determined from available literature. Intravenous vitamin K and coagulation factors should be given to patients with major or life-threatening hemorrhage. The optimal dose and type of coagulation factor is not known. Conclusions: Vitamin K therapy is an effective treatment for INR prolongation in patients with coumarin-associated coagulopathy; coagulation factor replacement is required, in addition, in patients with major bleeding or with indication for immediate correction of their INR. Clinical trials powered to detect differences in rates of bleeding and thrombosis are now required to determine if vitamin K reduces the risk of bleeding without causing thrombosis in non-bleeding patients with prolonged INR.

Substances (5)

Related products
Procduct Name CAS Molecular Formula Supplier Price
Coumarin 91-64-5 C9H6O2 786 suppliers $5.00-$3179.91
Warfarin 81-81-2 C19H16O4 228 suppliers $19.00-$2055.90
ACENOCOUMAROL 152-72-7 C19H15NO6 138 suppliers $57.00-$1281.28
PHENPROCOUMON 435-97-2 C18H16O3 87 suppliers $60.00-$2475.00
VITAMIN K1 12001-79-5 C31H46O2 64 suppliers Inquiry

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