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Titolo:
The hemostatic effects of warfarin titration in post CABG patients in comparison to placebo treatment
Autore:
Walenga, JM; Hoppensteadt, D; Pifarre, R; Fox, NL; Forman, S; Hunninghake, DB; Campeau, L; Herd, JA; Hoogwerf, BJ; Hickey, A; Probstfield, JL; Terrin, ML;
Indirizzi:
Loyola Univ, Med Ctr, Dept Pathol, Maywood, IL 60153 USA Loyola Univ Maywood IL USA 60153 Ctr, Dept Pathol, Maywood, IL 60153 USA Cor Therapeut Inc, S San Francisco, CA USA Cor Therapeut Inc S San Francisco CA USA ut Inc, S San Francisco, CA USA Maryland Med Res Inst, Baltimore, MD USA Maryland Med Res Inst Baltimore MD USA d Med Res Inst, Baltimore, MD USA Univ Minnesota, Minneapolis, MN USA Univ Minnesota Minneapolis MN USAUniv Minnesota, Minneapolis, MN USA Montreal Heart Inst, Montreal, PQ H1T 1C8, Canada Montreal Heart Inst Montreal PQ Canada H1T 1C8 ntreal, PQ H1T 1C8, Canada Baylor Coll Med, Houston, TX 77030 USA Baylor Coll Med Houston TX USA 77030 ylor Coll Med, Houston, TX 77030 USA Cleveland Clin Fdn, Cleveland, OH 44195 USA Cleveland Clin Fdn Cleveland OH USA 44195 in Fdn, Cleveland, OH 44195 USA Cedars Sinai Med Ctr, Los Angeles, CA 90048 USA Cedars Sinai Med Ctr Los Angeles CA USA 90048 , Los Angeles, CA 90048 USA Univ Washington, Seattle, WA 98195 USA Univ Washington Seattle WA USA 98195 iv Washington, Seattle, WA 98195 USA
Titolo Testata:
JOURNAL OF THROMBOSIS AND THROMBOLYSIS
fascicolo: 2, volume: 11, anno: 2001,
pagine: 143 - 149
SICI:
0929-5305(200104)11:2<143:THEOWT>2.0.ZU;2-W
Fonte:
ISI
Lingua:
ENG
Soggetto:
ISCHEMIC-HEART-DISEASE; PLASMINOGEN-ACTIVATOR INHIBITOR; AORTOCORONARY BYPASS-SURGERY; OPTIMAL THERAPEUTIC RANGE; FIXED MINIDOSE WARFARIN; ORAL ANTICOAGULATION; VENOUS THROMBOSIS; JOINT REPLACEMENT; RISK FACTOR; PROPHYLAXIS;
Keywords:
warfarin; anticoagulants; hemostasis; coronary artery bypass;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
30
Recensione:
Indirizzi per estratti:
Indirizzo: Walenga, JM Loyola Univ, Med Ctr, Dept Pathol, 2160 S 1st Ave, Maywood, IL60153 USA Loyola Univ 2160 S 1st Ave Maywood IL USA 60153 , IL 60153 USA
Citazione:
J.M. Walenga et al., "The hemostatic effects of warfarin titration in post CABG patients in comparison to placebo treatment", J THROMB TH, 11(2), 2001, pp. 143-149

Abstract

Background: Since coronary artery bypass graft patients remain at risk of coronary artery and bypass graft occlusion after successful surgery, adjunct treatment regimens are under investigation. In a study of the patients ofthe multicenter Post Coronary Artery Bypass Graft (Post CABG) Trial, 1 mg warfarin was found to have no important effect on coagulation parameters. Study design: The effects of 1, 2 and 3 mg warfarin were evaluated at six-week intervals in 20 Post CABG Trial patients receiving titrated dose increases in comparison to 20 patients of similar age, gender and time from CABGtreated with placebo. Results: International normalized ratio (INR) values increased with warfarin dose increments for 1, 2, and 3 mg, respectively (0.95 +/-0.16, 1.08 +/-0.19, and 1.34 +/-0.39) and in comparison to placebo treated patients (dosextreatment p <0.001). Factor VII coagulant activity decreased with warfarintitration (1 mg, 119.0 +/- 18.3 %; 2 mg, 100.6 +/- 32.8 %; 3 mg, 95.0 +/- 27.8 %) and in comparison to placebo (dosextreatment p=0.008). Levels of prothrombin fragment F1.2, tissue plasminogen activator, fibrinogen and von Willebrand factor were unchanged with warfarin dose increments and in comparison to placebo. Conclusions: At doses up to 3 mg, warfarin acts on the INR through a reduction of factor VII with no effect on the fibrinolytic system, fibrinogen orvon Willebrand factor. At these doses F1.2 did not document reduced coagulation activity. The observations of this study were consistent with the decision in the Post CABG Trial to increase the warfarin dose above 1 mg to achieve a distinct effect of warfarin that was less than full anticoagulation.

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Documento generato il 27/01/20 alle ore 01:25:24