Poor correlation of supratherapeutic international normalised ratio and vitamin K-dependent procoagulant factor levels during warfarin therapy

Ravindra Sarode, Ajay Rawal, Ray Lee, Yu Min Shen, Eugene P. Frenkel

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

Patients with a supratherapeutic international normalised ratio (ST-INR) are at risk for bleeding. ST-INR is corrected by withholding warfarin therapy and often by supplementing vitamin K or providing vitamin K-dependent factors; the exact therapeutic decision is based on the extent of the prolonged INR. Currently, ST-INRs are frequently observed in clinical practice due to the use of sensitive recombinant tissue thromboplastin reagents and automation. However, there are scant data correlating an ST-INR with various vitamin K-dependent factors. This prospective cohort study, set in a large tertiary care teaching hospital for the University of Texas Southwestern Medical Center at Dallas, defined the relationship between ST-INR (>5·0) and measured vitamin K-dependent procoagulant factors. Prothrombin time, INR and vitamin K-dependent factors II, VII, IX and X were measured in 78 patients with an INR > 5·0 (ST-INR) who were on warfarin therapy for more than 2 months. There was no significant relationship between the ST-INR and levels of important vitamin K-dependent factors II and X. These data support the recent guidelines that the management of an INR > 5·0 should be driven by the clinical determinants rather than specific INR values per se.

Original languageEnglish (US)
Pages (from-to)604-607
Number of pages4
JournalBritish Journal of Haematology
Volume132
Issue number5
DOIs
StatePublished - Mar 2006

Fingerprint

International Normalized Ratio
Vitamin K
Warfarin
Therapeutics
Factor X
Prothrombin
Factor VII
Automation
Prothrombin Time
Thromboplastin
Tertiary Healthcare
Teaching Hospitals
Cohort Studies

Keywords

  • International normalised ratio (INR)
  • Vitamin K therapy
  • Vitamin K-dependent factors
  • Warfarin

ASJC Scopus subject areas

  • Hematology

Cite this

Poor correlation of supratherapeutic international normalised ratio and vitamin K-dependent procoagulant factor levels during warfarin therapy. / Sarode, Ravindra; Rawal, Ajay; Lee, Ray; Shen, Yu Min; Frenkel, Eugene P.

In: British Journal of Haematology, Vol. 132, No. 5, 03.2006, p. 604-607.

Research output: Contribution to journalArticle

@article{0a316b70741647aeb384f4abfd9ecbba,
title = "Poor correlation of supratherapeutic international normalised ratio and vitamin K-dependent procoagulant factor levels during warfarin therapy",
abstract = "Patients with a supratherapeutic international normalised ratio (ST-INR) are at risk for bleeding. ST-INR is corrected by withholding warfarin therapy and often by supplementing vitamin K or providing vitamin K-dependent factors; the exact therapeutic decision is based on the extent of the prolonged INR. Currently, ST-INRs are frequently observed in clinical practice due to the use of sensitive recombinant tissue thromboplastin reagents and automation. However, there are scant data correlating an ST-INR with various vitamin K-dependent factors. This prospective cohort study, set in a large tertiary care teaching hospital for the University of Texas Southwestern Medical Center at Dallas, defined the relationship between ST-INR (>5·0) and measured vitamin K-dependent procoagulant factors. Prothrombin time, INR and vitamin K-dependent factors II, VII, IX and X were measured in 78 patients with an INR > 5·0 (ST-INR) who were on warfarin therapy for more than 2 months. There was no significant relationship between the ST-INR and levels of important vitamin K-dependent factors II and X. These data support the recent guidelines that the management of an INR > 5·0 should be driven by the clinical determinants rather than specific INR values per se.",
keywords = "International normalised ratio (INR), Vitamin K therapy, Vitamin K-dependent factors, Warfarin",
author = "Ravindra Sarode and Ajay Rawal and Ray Lee and Shen, {Yu Min} and Frenkel, {Eugene P.}",
year = "2006",
month = "3",
doi = "10.1111/j.1365-2141.2005.05917.x",
language = "English (US)",
volume = "132",
pages = "604--607",
journal = "British Journal of Haematology",
issn = "0007-1048",
publisher = "Wiley-Blackwell",
number = "5",

}

TY - JOUR

T1 - Poor correlation of supratherapeutic international normalised ratio and vitamin K-dependent procoagulant factor levels during warfarin therapy

AU - Sarode, Ravindra

AU - Rawal, Ajay

AU - Lee, Ray

AU - Shen, Yu Min

AU - Frenkel, Eugene P.

PY - 2006/3

Y1 - 2006/3

N2 - Patients with a supratherapeutic international normalised ratio (ST-INR) are at risk for bleeding. ST-INR is corrected by withholding warfarin therapy and often by supplementing vitamin K or providing vitamin K-dependent factors; the exact therapeutic decision is based on the extent of the prolonged INR. Currently, ST-INRs are frequently observed in clinical practice due to the use of sensitive recombinant tissue thromboplastin reagents and automation. However, there are scant data correlating an ST-INR with various vitamin K-dependent factors. This prospective cohort study, set in a large tertiary care teaching hospital for the University of Texas Southwestern Medical Center at Dallas, defined the relationship between ST-INR (>5·0) and measured vitamin K-dependent procoagulant factors. Prothrombin time, INR and vitamin K-dependent factors II, VII, IX and X were measured in 78 patients with an INR > 5·0 (ST-INR) who were on warfarin therapy for more than 2 months. There was no significant relationship between the ST-INR and levels of important vitamin K-dependent factors II and X. These data support the recent guidelines that the management of an INR > 5·0 should be driven by the clinical determinants rather than specific INR values per se.

AB - Patients with a supratherapeutic international normalised ratio (ST-INR) are at risk for bleeding. ST-INR is corrected by withholding warfarin therapy and often by supplementing vitamin K or providing vitamin K-dependent factors; the exact therapeutic decision is based on the extent of the prolonged INR. Currently, ST-INRs are frequently observed in clinical practice due to the use of sensitive recombinant tissue thromboplastin reagents and automation. However, there are scant data correlating an ST-INR with various vitamin K-dependent factors. This prospective cohort study, set in a large tertiary care teaching hospital for the University of Texas Southwestern Medical Center at Dallas, defined the relationship between ST-INR (>5·0) and measured vitamin K-dependent procoagulant factors. Prothrombin time, INR and vitamin K-dependent factors II, VII, IX and X were measured in 78 patients with an INR > 5·0 (ST-INR) who were on warfarin therapy for more than 2 months. There was no significant relationship between the ST-INR and levels of important vitamin K-dependent factors II and X. These data support the recent guidelines that the management of an INR > 5·0 should be driven by the clinical determinants rather than specific INR values per se.

KW - International normalised ratio (INR)

KW - Vitamin K therapy

KW - Vitamin K-dependent factors

KW - Warfarin

UR - http://www.scopus.com/inward/record.url?scp=33644885466&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33644885466&partnerID=8YFLogxK

U2 - 10.1111/j.1365-2141.2005.05917.x

DO - 10.1111/j.1365-2141.2005.05917.x

M3 - Article

C2 - 16445834

AN - SCOPUS:33644885466

VL - 132

SP - 604

EP - 607

JO - British Journal of Haematology

JF - British Journal of Haematology

SN - 0007-1048

IS - 5

ER -