To the Editor: The recently updated warfarin reversal guideline recommends prothrombin complex concentrate (PCC) dosing based on international normalised ratios (INRs), rather than fixed dosing.1 While achieving a target INR may be made more likely, this may be inconsequential clinically.2
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- 1. Tran HA, Chunilal SD, Harper PL, et al. An update of consensus guidelines for warfarin reversal. Med J Aust 2013; 198: 198-199. <MJA full text>
- 2. Leissinger CA, Blatt PM, Hoots WK, Ewenstein B. Role of prothrombin complex concentrates in reversing warfarin anticoagulation: a review of the literature. Am J Hematol 2008; 83: 137-143.
- 3. Sarode R, Rawal A, Lee R, et al. Poor correlation of supratherapeutic international normalised ratio and vitamin K-dependent procoagulant factor levels during warfarin therapy. Br J Haematol 2006; 132: 604-607.
- 4. Gatt A, Riddell A, van Veen JJ, et al. Optimizing warfarin reversal – an ex vivo study. J Thromb Haemost 2009; 7: 1123-1127.
- 5. Poller L. International normalised ratios (INR): the first 20 years. J Thromb Haemost 2004; 2: 849-860.
- 6. Le-Kim L, Kerr D, Kelly A. Are patients on warfarin with high INR treated according to published guidelines? The Internet Journal of Hematology 2009; 5. doi: 10.5580/24f2. http://ispub.com/IJHE/5/1/12484 (accessed Mar 2013).
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