The Significance of Haemorrhage During the Treatment of Patients With the Coumarin Anticoagulants

Problems Encountered in Long‐term Treatment with Anticoagulants

“…This is in agreement with the fact that patients in this category periodically develop congestive heart failure with hepatic congestion, which tends to increase the risk of bleeding during anticoagulanl therapy (3, 14, 16). Age is significantly correlated with the development of bleedings (3, 16,17). In our study, about two thirds of the bleeding episodes occurred in the age group 60-69 years.…”

“…No bleeding was observed when the PP% was above 25. Warfarin resulted in relatively fewer bleeding episodes and more PP % values within the desired range (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25) than phenprocoumon and bishydroxycoumarin. The role of age, but not of moderate hypertension, as a risk factor was confirmed.…”

“…Relation between bleeding and PP %. Peyman ( 16) found that haemorrhage during anticoagulant therapy was usually associated with an unduly increased prothrombin time (i.e. longer than three times the control value using the Quick method of determination) not only on the day of onset of the haemorrhage but also during the previous three days.…”

Right Ventricular Dysfunction Complicates Time in Therapeutic Range in Heart Failure Patients Receiving Warfarin

“…Although the effects of factors such as drug interactions, food interactions, age and CYP2C9 gene polymorphism are well documented in numerous studies, the effects of disease states such as liver disease, hyperthyroidism and hypothyroidism have been less studied, and the number of studies investigating the effects of heart failure (HF) is limited [5,6] . HF was demonstrated to be associated with an exaggerated response to vitamin K antagonists (VKA) [7,8] , an increased risk of bleeding [9,10] , excess anticoagulation [11,12] or delayed correction of excess anticoagulation [13] . Additionally, clinical evidence of right ventricular (RV) failure was shown to be associated with excess anticoagulation in 2 previously published clinical studies [8,14] .…”