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Vitamin K antagonist reversal strategies: Systematic review and network meta-analysis from the AABB.
- Source :
-
Transfusion . Aug2022, Vol. 62 Issue 8, p1652-1661. 10p. - Publication Year :
- 2022
-
Abstract
- <bold>Background: </bold>Anticoagulation requires urgent reversal in cases of life-threatening bleeding or invasive procedures.<bold>Study Design and Methods: </bold>Network meta-analysis for comparing the safety and efficacy of warfarin reversal strategies including plasma and prothrombin complex concentrates (PCCs).<bold>Results: </bold>Seven studies including 594 subjects using reversal agents plasma, 3-factor-PCC (Uman Complex and Konyne), and 4-factor-PCC (Beriplex/KCentra, Octaplex, and Cofact) met inclusion criteria. Compared with plasma, patients receiving Cofact probably have a higher rate of international normalized ratio (INR) correction (risk difference [RD] 499 more per 1000 patients, 95% confidence interval [CI], 176-761, low certainty[LC]); higher reversal of bleeding (323 more per 1000 patients, 11-344 more, LC); and fewer transfusion requirements (0.96 fewer units, 1.65-0.27 fewer, LC). Patients receiving Beriplex/KCentra probably have a higher rate of INR correction (476 more per 1000 patients, 332-609 more, LC); higher reversal of bleeding (127 more per 1000 patients, 43 fewer to 236 more); and similar transfusion requirements (0.01 fewer units, 0.31 fewer to 0.28 more, high/moderate certainty). Patients receiving Octaplex probably have a higher rate of INR correction (RD 579 more per 1000 patients, 189-825 more, LC).<bold>Conclusions: </bold>PCCs probably provide an advantage in INR reversal compared to plasma. There was no added risk of adverse events with PCCs. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 00411132
- Volume :
- 62
- Issue :
- 8
- Database :
- Academic Search Index
- Journal :
- Transfusion
- Publication Type :
- Academic Journal
- Accession number :
- 158391936
- Full Text :
- https://doi.org/10.1111/trf.17010