In this multicenter randomized controlled trial of nonbleeding patients with INR levels between 4.5-10, they were randomized to placebo or vitamin K 1.25mg orally. At 90 days, there was no difference between the groups in bleeding (each 16%), or thromboembolism (1%), although the INR did decrease faster in the vitamin K group (1.4 in placebo versus 2.8 in vitmain K, in the 1st day) (abstract). This is fairly consistent with the current ACCP guidelines, which suggest omitting 1-2 doses of warfarin for INR levels 5-9 (with vitamin K reserved for patients at high risk of bleeding) (guidelines).
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March 3, 2009 |
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About the Author: Danielle Scheurer
Danielle Scheurer, MD, MSCR, SFHM is a clinical hospitalist and the Chief Quality Officer at the Medical University of South Carolina in Charleston, South Carolina, where she also serves as Assistant Professor of Medicine. She is a graduate of the University of Tennessee College of Medicine, completed her residency at Duke University, and completed her Masters in Clinical Research at the Medical University of South Carolina. She is also the President of SHM's Board of Directors and previously served as Physician Editor of The Hospitalist, SHM's monthly newsmagazine.
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