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Comparison of the efficacy and safety profiles of intravenous vitamin K and fresh frozen plasma as treatment of warfarin-related over-anticoagulation in patients with mechanical heart valves.
- Source :
-
The American journal of cardiology [Am J Cardiol] 2006 Feb 01; Vol. 97 (3), pp. 409-11. Date of Electronic Publication: 2005 Dec 01. - Publication Year :
- 2006
-
Abstract
- Patients on warfarin for mechanical heart valves are at increased risk for thromboembolic events and intracranial hemmorhage. In current guidelines, a low dose of vitamin K is the recommended treatment for moderate over-anticoagulation based on studies in which only minority patients participating had mechanical heart valves. We performed a randomized controlled trial to compare the efficacy and safety profile of low-dose intravenous vitamin K and fresh frozen plasma (FFP) for patients with mechanical heart valves and mild to moderate over-anticoagulation (international normalized ratio [INR] 4 to 7). In a 24-month period, we randomized 102 patients to (1) vitamin K or (2) FFP. The baseline INR at presentation between the vitamin K group and the FFP group was 4.61 +/- 0.007 vs 4.78 +/- 0.07 (p = 0.11). Six hours after treatment, patients in the FFP group had a significantly lower mean INR compared with the vitamin K group (2.75 +/- 0.06 vs 3.44 +/- 0.10, p = 0.01). No patient in both groups had over-correction (INR < 2). One week later, there was no significant difference in mean INR between both groups (2.7 +/- 0.11 vs 2.56 +/- 0.12, p = 0.41). Fifty-eight percent of patients in the FFP group and 51% in the vitamin K group had an INR within the target range. There were no adverse reactions or outcomes in both groups. In conclusion, intravenous low-dose vitamin K is a safe alternative to FFP infusion for warfarin overdose in patients with mechanical heart valves.
- Subjects :
- Blood Component Transfusion
Female
Heart Valve Diseases surgery
Heart Valve Prosthesis Implantation
Humans
Infusions, Intravenous
International Normalized Ratio
Male
Middle Aged
Prospective Studies
Treatment Outcome
Anticoagulants adverse effects
Blood Coagulation Disorders chemically induced
Blood Coagulation Disorders drug therapy
Coagulants administration & dosage
Heart Valve Prosthesis
Plasma
Vitamin K administration & dosage
Warfarin adverse effects
Subjects
Details
- Language :
- English
- ISSN :
- 0002-9149
- Volume :
- 97
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- The American journal of cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 16442406
- Full Text :
- https://doi.org/10.1016/j.amjcard.2005.08.062