Oral vitamin K effectively treats international normalised ratio (INR) values in excess of 10: Results of a prospective cohort study

Mark A. Crowther; David Garcia; Walter Ageno; Luqi Wang; Dan M. Witt; Nathan P. Clark; Mark D. Blostein; Susan R. Kahn; Sam Schulman; Michael Kovacs; Marc A. Rodger; Philip Wells; David Anderson; Jeffrey Ginsberg; Rita Selby; Sergio Siragusa; Mauro Silingardi; Mary Beth B. Dowd; Clive Kearon

doi:10.1160/TH09-12-0822

Oral vitamin K effectively treats international normalised ratio (INR) values in excess of 10: Results of a prospective cohort study

Mark A. Crowther, David Garcia, Walter Ageno, Luqi Wang, Dan M. Witt, Nathan P. Clark, Mark D. Blostein, Susan R. Kahn, Sam Schulman, Michael Kovacs, Marc A. Rodger, Philip Wells, David Anderson, Jeffrey Ginsberg, Rita Selby, Sergio Siragusa, Mauro Silingardi, Mary Beth B. Dowd, Clive Kearon

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32 Scopus citations

Abstract

Unanticipated elevation of the INR is common in patients receiving warfarin. We performed a prospective cohort study of 107 warfarintreated patients with INR values of more than 10 who received a single 2.5 mg dose of oral vitamin K. During the first week, one patient experienced major bleeding, and one died. In the first 90 days after enrolment four patients had major bleeding (3.7%, 1.0% to 9.3%), eight patients (7.5%, 3.3% to 14.2%) died and two had objectively confirmed thromboembolism. Based on our low rate of observed major bleeding we conclude that 2.5 mg of oral vitamin K is a reasonable treatment for patients with INR values of more than 10 who are not actively bleeding.

Original language	English
Pages (from-to)	118-121
Number of pages	4
Journal	Thrombosis and Haemostasis
Volume	104
Issue number	1
DOIs	https://doi.org/10.1160/TH09-12-0822
State	Published - Jul 2010
Externally published	Yes

Keywords

Acquired coagulation disorders
Haemostasis
Oral anticoagulants
Thrombosis

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10.1160/TH09-12-0822

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Crowther, M. A., Garcia, D., Ageno, W., Wang, L., Witt, D. M., Clark, N. P., Blostein, M. D., Kahn, S. R., Schulman, S., Kovacs, M., Rodger, M. A., Wells, P., Anderson, D., Ginsberg, J., Selby, R., Siragusa, S., Silingardi, M., Dowd, M. B. B., & Kearon, C. (2010). Oral vitamin K effectively treats international normalised ratio (INR) values in excess of 10: Results of a prospective cohort study. Thrombosis and Haemostasis, 104(1), 118-121. https://doi.org/10.1160/TH09-12-0822

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title = "Oral vitamin K effectively treats international normalised ratio (INR) values in excess of 10: Results of a prospective cohort study",

abstract = "Unanticipated elevation of the INR is common in patients receiving warfarin. We performed a prospective cohort study of 107 warfarintreated patients with INR values of more than 10 who received a single 2.5 mg dose of oral vitamin K. During the first week, one patient experienced major bleeding, and one died. In the first 90 days after enrolment four patients had major bleeding (3.7%, 1.0% to 9.3%), eight patients (7.5%, 3.3% to 14.2%) died and two had objectively confirmed thromboembolism. Based on our low rate of observed major bleeding we conclude that 2.5 mg of oral vitamin K is a reasonable treatment for patients with INR values of more than 10 who are not actively bleeding.",

keywords = "Acquired coagulation disorders, Haemostasis, Oral anticoagulants, Thrombosis",

author = "Crowther, {Mark A.} and David Garcia and Walter Ageno and Luqi Wang and Witt, {Dan M.} and Clark, {Nathan P.} and Blostein, {Mark D.} and Kahn, {Susan R.} and Sam Schulman and Michael Kovacs and Rodger, {Marc A.} and Philip Wells and David Anderson and Jeffrey Ginsberg and Rita Selby and Sergio Siragusa and Mauro Silingardi and Dowd, {Mary Beth B.} and Clive Kearon",

year = "2010",

month = jul,

doi = "10.1160/TH09-12-0822",

language = "English",

volume = "104",

pages = "118--121",

journal = "Thrombosis and Haemostasis",

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Crowther, MA, Garcia, D, Ageno, W, Wang, L, Witt, DM, Clark, NP, Blostein, MD, Kahn, SR, Schulman, S, Kovacs, M, Rodger, MA, Wells, P, Anderson, D, Ginsberg, J, Selby, R, Siragusa, S, Silingardi, M, Dowd, MBB & Kearon, C 2010, 'Oral vitamin K effectively treats international normalised ratio (INR) values in excess of 10: Results of a prospective cohort study', Thrombosis and Haemostasis, vol. 104, no. 1, pp. 118-121. https://doi.org/10.1160/TH09-12-0822

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AU - Garcia, David

AU - Ageno, Walter

AU - Wang, Luqi

AU - Witt, Dan M.

AU - Clark, Nathan P.

AU - Blostein, Mark D.

AU - Kahn, Susan R.

AU - Schulman, Sam

AU - Kovacs, Michael

AU - Rodger, Marc A.

AU - Wells, Philip

AU - Anderson, David

AU - Ginsberg, Jeffrey

AU - Selby, Rita

AU - Siragusa, Sergio

AU - Silingardi, Mauro

AU - Dowd, Mary Beth B.

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AB - Unanticipated elevation of the INR is common in patients receiving warfarin. We performed a prospective cohort study of 107 warfarintreated patients with INR values of more than 10 who received a single 2.5 mg dose of oral vitamin K. During the first week, one patient experienced major bleeding, and one died. In the first 90 days after enrolment four patients had major bleeding (3.7%, 1.0% to 9.3%), eight patients (7.5%, 3.3% to 14.2%) died and two had objectively confirmed thromboembolism. Based on our low rate of observed major bleeding we conclude that 2.5 mg of oral vitamin K is a reasonable treatment for patients with INR values of more than 10 who are not actively bleeding.

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Oral vitamin K effectively treats international normalised ratio (INR) values in excess of 10: Results of a prospective cohort study

Abstract

Keywords

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