Until recently, warfarin has been the primary treatment of venous thromboembolism (VTE). Limited data are available regarding physician attitudes toward anticoagulant choice in the setting of novel oral anticoagulant (NOAC) availability. This study sought to evaluate attending physician attitudes toward NOACs. A survey was sent to attending physicians from internal medicine (primary care and ho...

Prothrombin complex concentrates (PCC) are recommended for urgent warfarin reversal. However, disagreement exists regarding the proper dosing strategy (i.e. fixed vs. weight-based). We measured the in vitro effect of PCC dosing on international normalised ratio (INR) and factor activity. Plasma from warfarin-anticoagulated patients with stable INRs was collected. PCC doses of 1,000, 2,000 and 3...

Background: Many cardiovascular diseases may require lifelong anticoagulation therapy. Warfarin is the most prescribed medication in this regard, however, it has serious side effects. Recently the new issue regarding to warfarin dosing is considered in which some single nucleotide polymorphisms (SNPs) affecting cytochrome P450 system can impact on warfarin metabolism and dosing. Methods: 230 c...

1316 June 2014 T novel oral anticoagulation agents (NOACs) include dabigatran, a direct thrombin inhibitor, and rivaroxaban, apixaban, and edoxaban, direct Factor Xa inhibitors, indicated for either stroke prevention with nonvalvular atrial fibrillation or thromboprophylaxis.1,2 The NOACs are administered orally, have predictable onsets within 2 to 4 h, and an offset more rapid than warfarin. A...

Background: Warfarin is a common anticoagulant drug that has a narrow therapeutic index; higher dose causes excessive bleeding and lower dose leads to cerebrovascular clotting and stroke in patients. Genetic factors that have been associated with warfarin response are the genes of cytochrome P450 2C9 (CYP2C9), which metabolize the more active S-enantiomer of warfarin, and vitamin K epoxide redu...

TOPIC: Critical Care TYPE: Medical Student/Resident Case Reports INTRODUCTION: Acute hip fracture is deemed an emergent orthopedic intervention, such interventions can be complicated if the patient on anticoagulation for chronic thromboembolic disease. We are presenting a case of elderly who presented with acute elevated INR that required rapid reversal, which unfortunately led to fatal event. ...

TOPIC: Cardiothoracic Surgery TYPE: Medical Student/Resident Case Reports INTRODUCTION: Warfarin–induced hemopericardium is rare outside cardiac surgery and can occur due to excessive anticoagulation and/or uremia from anticoagulant–related nephropathy (ACRN). We present a severe case of recurrent warfarin–related complicated by arrest requiring repeat pericardial window. CASE PRESENTATION: A 7...