Optimal Initial Dose Adjustment of Warfarin in Orthopedic Patients

Lenzini, Petra A.; Grice, Gloria R.; Milligan, Paul E.; Gatchel, Susan K.; Deych, Elena; Eby, Charles S.; Burnett, R. Stephen J.; Clohisy, John C.; Barrack, Robert L.; Gage, Brian F.

doi:10.1345/aph.1k197

Cited by 27 publications

(20 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Estimated initial doses and stable maintenance doses did not differ among the group of genotypes, indicating that our pharmacogenetically based warfarin-dosing algorithm could effectively predict the actual warfarin maintenance dose, providing clinicians with a reliable tool for managing successful anticoagulation (33)(34)(35). Homozygous carriers of VKORC1/CYP2C9 defective alleles required the lowest daily maintenance dose of 1 mg, while the highest dose of 6 mg per day was needed by homozygous "wild" type carriers.…”

Section: Discussionmentioning

confidence: 91%

Prevalence of genetic polymorphisms of CYP2C9 and VKORC1 — Implications for warfarin management and outcome in Croatian patients with acute stroke

Šupe

Božina

Matijević

et al. 2014

Journal of the Neurological Sciences

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 91%

Prevalence of genetic polymorphisms of CYP2C9 and VKORC1 — Implications for warfarin management and outcome in Croatian patients with acute stroke

Šupe

Božina

Matijević

et al. 2014

Journal of the Neurological Sciences

View full text Add to dashboard Cite

“…Intraoperatively, the INR level has been found to closely correlate blood loss. Increased intra-operative blood loss can cause decrease in level of clotting factors and can lead to further elevation in post-op INR (Lenzini et al, 2007). This could inflate patients INR level and leads to oversensitive to Warfarin in postoperative patients (Rahman et al, 2006).…”

Section: Discussionmentioning

confidence: 99%

Rivaroxaban and its Effect on International Normalised Ratio-A Prospective Study of 28 Hip and Knee Arthroplasty Patients

Yeo¹,

Eranki²,

Pillai³

et al. 2012

American Medical Journal

View full text Add to dashboard Cite

Problem statement:Rivaroxaban is an orally active, competitively reversible antagonist of activated factor Xa. The purpose of this study is to comment on Riveroxaban's effect on INR. Approach: At the Queen Elizabeth Hospital, all patients undergoing elective anthroplasty were anticoagulated with 10mg of Rivaroxaban. All patients had INR measurements for 3 days post operatively. Further 16 patients had weekly INR follow follow up for the reminder of their therapy. Measurements between 0.2-1.2 were classified normal, 1.3-1.4 elevated and INR>1.4 high. Results: On day 1 after Rivaroxaban was commenced, 67.9% of patients recorded high INR value of >1.4 while 7.1% of patients had normal value of INR value (0.8-1.2). However, the number of patient with normal value of INR increased over next 2 days. On the third day after Rivaroxaban was commenced, 35.7% of the patients recorded a normal INR value while 32.1% of the studied patients had recorded mild elevated INR value. 32.1% of the studied patients had high INR value. All patients had an INR greater than 1.1. In the first 3 days, the maximum INR reached was 3.1. In patients who. All patients with a normal INR on day 1 remined normal throughout their course. 4 patients with an elevated INR on day 1 normalised by day 3. 8 patients had an INR trend upwards from day 1-2. 3 patients had a higher INR at day 3 compared to day 1. Of the 16 pateints followed up till the end of their therapy, 68.8% patients had a normal, 18.8% elevated and 12.5% patients had a high INR. Conclusion: Rivaroxaban has been proven as an effective alternate to existing anticoagulats in tehrms of patient compliance, rates of thrombus and bleeding risks. This study successfully demonstrates that Rivaroxaban leads to a trancient increase in INR in the majority of pateints in the first 72 h. Nil litrature exists on the effect of Rivaroxaban on prothrombin time and appropriate reversal and mangemetn of pateints who require further surgical intervention. Further research is required into invistigating the cause and effect of this increase.

show abstract

“…Su diseño retrospectivo demuestra la asociación entre dosis bajas y genotipo, pero no fue diseñado para realizar recomendaciones clínicas; ello requeriría un estudio prospectivo, tal como los que incluimos en las referencias [4][5][6] , entre otros, que han contribuido a la generación de algoritmos como el que se presenta en www.warfarindosing.com. Es por ello que nuestro trabajo se plantea como una base para promover otros estudios que permitan evaluar la utilidad clínica de la introducción del tamizaje genético de VKORC1 y/o CYP2C9 en pacientes chilenos.…”

Section: Sr Editorunclassified

Efecto del polimorfismo -1639G > A del gen VKORC1 sobre la dosis de anticoagulantes orales acenocumarol y warfarina en pacientes chilenos: posibles modelos de herencia

López-Hernández

2016

Rev. méd. Chile

View full text Add to dashboard Cite

Efecto del polimorfismo -1639G > A del gen VKORC1 sobre la dosis de anticoagulantes orales acenocumarol y warfarina en pacientes chilenos: posibles modelos de herencia Effect of the -1639G > A polymorphism of the VKORC1 gene on the dose of oral anticoagulants acenocoumarol, and warfarin in Chilean patients: alternative models of inheritance Sr. Editor: He leído con gran interés el artículo de Repetto et al 1 donde presentan una muy interesante asociación epidemiológica genética entre la variante alélica A del polimorfismo -1639 G > A con la dosis empleada de los anticoagulantes orales acenocumarol y warfarina en pacientes chilenos (acenocumarol: OR = 9,60; 95% IC 2, 12; valor p < 0,0001, warfarina: OR = 18,71; 95% IC 2,12; valor p = 0,0007)

show abstract

Optimal Initial Dose Adjustment of Warfarin in Orthopedic Patients

Abstract: We developed and validated algorithms that estimate therapeutic warfarin doses based on clinical factors and INR response available after 2-3 days of warfarin therapy. The algorithms are implemented online at www.WarfarinDosing.org.

Cited by 27 publications

References 28 publications

Prevalence of genetic polymorphisms of CYP2C9 and VKORC1 — Implications for warfarin management and outcome in Croatian patients with acute stroke

Prevalence of genetic polymorphisms of CYP2C9 and VKORC1 — Implications for warfarin management and outcome in Croatian patients with acute stroke

Rivaroxaban and its Effect on International Normalised Ratio-A Prospective Study of 28 Hip and Knee Arthroplasty Patients

Efecto del polimorfismo -1639G > A del gen VKORC1 sobre la dosis de anticoagulantes orales acenocumarol y warfarina en pacientes chilenos: posibles modelos de herencia

Contact Info

Product

Resources

About