0
Sign In  | Subscribe
3 December 2002, Vol 137, No. 11>
Summaries for Patients | 3 December 2002

A New Way To Reverse Excessive Blood Thinning from Warfarin FREE

[+] Article and Author Information

The summary below is from the full report titled “Reversal of Warfarin-Induced Excessive Anticoagulation with Recombinant Human Factor VIIa Concentrate.” It is in the 3 December 2002 issue of Annals of Internal Medicine (volume 137, pages 884-888). The authors are RAE Deveras and CM Kessler.


Ann Intern Med. 2002;137(11):I-41. doi:10.7326/0003-4819-137-11-200212030-00004
Text Size: A A A

What is the problem and what is known about it so far?

Warfarin is a drug that “thins the blood” by interfering with normal blood clotting. Doctors prescribe warfarin to prevent blood clots in the legs, lungs, heart, and brain. People who take warfarin need frequent blood tests to make sure that the extent of blood thinning is appropriate. If the blood is thinned too much, serious bleeding from the nose or lungs or in the urine and gastrointestinal tract can occur. Doctors use different methods to reverse excessive blood thinning (excessive anticoagulation) from warfarin. If the degree of thinning is high but there is no bleeding, doctors decrease or stop warfarin therapy and watch the patient carefully. They also may give vitamin K to speed the reversal of warfarin's effects. If the patient is bleeding or needs an immediate procedure that could be complicated by bleeding (such as surgery), doctors give blood products (such as fresh-frozen plasma) through the vein to rapidly reverse anticoagulation from warfarin. Sometimes it is difficult to obtain and give the blood products quickly, and blood products have potentially serious side effects. Other ways to rapidly counteract anticoagulation from warfarin are needed.

Why did the researchers do this particular study?

To see whether a human-made agent (human recombinant factor VIIa concentrate, or rFVIIa) that was originally developed to control bleeding in patients with hemophilia would safely and rapidly reverse anticoagulation from warfarin.

Who was studied?

The study included 13 patients who had highly thinned blood from warfarin and needed rapid reversal of anticoagulation.

How was the study done?

The researchers gave each patient a single dose of rFVIIa in the vein. They did blood tests (prothrombin times and international normalized ratios) that measured the amount of blood thinning before and after they gave rFVIIa. They also assessed whether bleeding was stopped or prevented and whether rFVIIa had any harmful effects.

What did the researchers find?

All patients had immediate reversal of blood thinning with rFVIIa. Four patients who were bleeding from too much warfarin stopped bleeding. No patients who had invasive procedures developed bleeding complications from too much anticoagulation. No adverse side effects were reported.

What were the limitations of the study?

The study was small and did not directly compare different ways of reversing anticoagulation from warfarin.

What are the implications of the study?

Recombinant factor VIIa is a promising new way to rapidly reverse too much anticoagulation from warfarin. We now need studies that directly compare benefits, harms, and costs of rFVIIa with traditional ways of reversing too much anticoagulation.

Figures

Tables

References

Letters

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Compression-Only CPR: Pushing the Science Forward
Cone
AAM 2010;304:1493-1495.
All you need to read in the other general jounals
BMJ 2010;341:c5893-c1494.

Comments

Submit a Comment
Submit a Comment

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

Toolkit

Buy This Article

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Register Now for a free account
Advertisement

Related Content

Customize your page view by dragging & repositioning the boxes below.

Topic Collections
PubMed Articles
Protecting the Brain and the Heart: Antithrombotic Treatment in Nonvalvular Atrial Fibrillation.
Angiology Issue date: 2013 Apr 25
Dabigatran for the Prevention of Stroke and Systemic Embolism in Atrial Fibrillation: A NICE Single Technology Appraisal.
PharmacoEconomics Issue date: 2013 Apr 26

Annals of Internal Medicine

Other Resources

Copyright © 2013 The American College of Physicians. All Rights Reserved.
Print ISSN: 0003-4819 | Online ISSN: 1539-3704

Buy This Article

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Register Now for a free account
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.
(Required)
(Required)