Skin necrosis is a rare complication of warfarin therapy that occurs between the third and 10th days of treatment. The pathogenesis of warfarin-induced skin necrosis is attributable to the emergence of a transient hypercoagulable state. The condition most commonly involves skin areas with abundant subcutaneous adipose tissue such as the breasts, buttocks, abdomen, thighs, and the extremities. W...

This study details warfarin use in a large pediatric population followed in a central anticoagulation clinic. A prospective, consecutive cohort of nonselected children were studied. Patients were divided into groups by age, target international normalized ratio (INR) range, disease, medications, and vitamin K supplemented enteral nutrition use. Groups were analyzed on multiple aspects of warfar...

Cytochrome P450 oxidoreductase (POR) is required for drug metabolism by all microsomal cytochrome P450 enzymes. The aim of this study was to investigate whether any of the common single nucleotide polymorphisms (SNPs) in the POR gene and its flanking intergenic sequences correlate with interindividual variations in the warfarin maintenance dose (which is determined partly by rates of warfarin m...

BACKGROUND Older adults are at substantial risk for cardiovascular disorders that may require anticoagulation therapy. Those on warfarin therapy report dissatisfaction and reduced quality of life (QOL) resulting from the treatment. Advances in the area of mobile health (mHealth) technology have resulted in the design and development of new patient-centric models for the provision of personalize...

BACKGROUND Accelerated progression of aortic stiffness in patients with advanced chronic kidney disease is not well explained by the traditional cardiovascular risk factors. We hypothesized that vitamin K deficiency may result in an accelerated progression of aortic stiffness in the pro-calcifying uremic milieu. METHOD Eighteen hemodialysis (HD) patients on warfarin were matched to 54 HD pati...

Purpose: To assess the level of knowledge on warfarin therapy and anticoagulation control, and explore the association between knowledge and anticoagulation control in a section of Saudi population. Methods: A cross-sectional prospective survey was conducted over a 4-week period in 2013 at King Khalid University Hospital outpatient anticoagulant clinic in Riyadh, Saudi Arabia. Adult patients wh...

OBJECTIVE A combination of warfarin and aspirin is associated with increased bleeding compared with warfarin monotherapy. The aim of the study was to investigate the incidence and appropriateness of the combination of warfarin and aspirin in patients with atrial fibrillation (AF) or mechanical heart valve (MHV). METHODS This cross-sectional study included consecutive patients with AF or MHV o...

PURPOSE We investigated risk factors affecting the onset of postoperative hemorrhage after tooth extraction in patients receiving oral antithrombotic therapy. PATIENTS AND METHODS A total of 443 tooth extractions were performed in 382 patients. All extractions were performed while continuing conventional antithrombotic therapy, and local hemostatic measures were performed. RESULTS Among the...

a case to illustrate the utility of genetic screening in warfarin (Coumadin®) management is reported. a 45 year-old woman of puerto rican ancestry was admitted to the emergency room twice within one month with chest pain. she was diagnosed with congestive heart failure, which was stabilized both times. at her second release, warfarin therapy was initiated at 5 mg/ day to prevent thrombus format...

INTRODUCTION Vitamin K antagonists of the coumarin type are widely used oral anticoagulants. OBJECTIVE We developed a transition algorithm for the maintenance dosages of three frequently used coumarins: warfarin, phenprocoumon and acenocoumarol. METHODS The study was conducted at the Leiden Anticoagulation Clinic. Patients were participants in a trial of which the main objective was to comp...