Paul R. Casner, MD, PhD
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Casner PR. Warfarin: Less May Be Better. Ann Intern Med. 1997;127:332. doi: 10.7326/0003-4819-127-4-199708150-00017
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Published: Ann Intern Med. 1997;127(4):332.
TO THE EDITOR:
In their report on loading doses of warfarin therapy, Harrison and colleagues  concluded that a 5-mg loading dose of warfarin produced less excess anticoagulation than a 10-mg loading dose. The authors base this conclusion on the fact that fewer patients in the 5-mg group than in the 10-mg group had an INR greater than 3.0. Because the specific values of the greater-than-3.0 INRs are not given, we do not know whether these elevations are clinically significant. For example, INRs of 3.1, 3.2, or 3.3 could be classified as “excess anticoagulation,” but these elevations are not clinically significant.
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