A low fixed dose of prothrombin complex concentrate is cost effective in emergency reversal of vitamin K antagonists.

نویسندگان

  • Nakisa Khorsand
  • Lisette Giepmans
  • Karina Meijer
  • Reinier M van Hest
  • Nic J G M Veeger
چکیده

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An observational, prospective, two-cohort comparison of a fixed versus variable dosing strategy of prothrombin complex concentrate to counteract vitamin K antagonists in 240 bleeding emergencies.

BACKGROUND Despite years of experience with vitamin K antagonist-associated bleeding events, there is still no evidence to help identify the optimal treatment with prothrombin complex concentrates. Variable dosing and fixed dose strategies are being used. In this observational prospective two-cohort study, we aimed to assess the non-inferiority of a low fixed PCC dose (1,040 IU Factor IX) compa...

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Antidotes for novel oral anticoagulants: current status and future potential.

The direct thrombin inhibitor dabigatran and the anti-Xa agents rivaroxaban, edoxaban, and apixaban are a new generation of oral anticoagulants. Their advantage over the vitamin K antagonists is the lack of the need for monitoring and dose adjustment. Their main disadvantage is currently the absence of a specific reversal agent. Dabigatran's, unlike the anti-Xa agents, absorption can be reduced...

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Prothrombin complex concentrate-related thrombotic risk following anticoagulation reversal.

Dear Sirs, We read with interest the report of the meta-analysis performed by Dentali et al. on the adverse events after prothrombin complex concentrate (PCC) use for the emergency reversal of vitamin K antagonists (1). The authors identified a low incidence of thrombotic events and a non-significant difference between fourand three-factor PCCs at 1.8% and 0.7%, respectively. We do not wish to ...

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Comparison of 3-Factor Prothrombin Complex Concentrate and Low-Dose Recombinant Factor VIIa for Warfarin Reversal

INTRODUCTION Prothrombin complex concentrate (PCC) and recombinant Factor VIIa (rFVIIa) have been used for emergent reversal of warfarin anticoagulation. Few clinical studies have compared these agents in warfarin reversal. We compared warfarin reversal in patients who received either 3 factor PCC (PCC3) or low-dose rFVIIa (LDrFVIIa) for reversal of warfarin anticoagulation. METHODS Data were...

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Emergency correction of coagulation before major surgery in two elderly patients on oral anticoagulation

Recommendations for urgent reversal of oral anticoagulation with vitamin K1 antagonists are largely derived from case series employing empirical dosing regimens with vitamin K1 and prothrombin complex concentrates. Data on the use of prothrombin complex concentrates in this indication are scarce in the elderly who are at high risk of both hemorrhagic and thrombotic complications. The two cases ...

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عنوان ژورنال:
  • Haematologica

دوره 98 6  شماره 

صفحات  -

تاریخ انتشار 2013