Erschienen in:
01.08.2011
Life-threatening bleeding under vitamin K antagonists in spite of an INR in the therapeutic range
verfasst von:
Mathilde Gavillet, Claire Abbal, Sabine Schmidt, Jasmine Nötzli, Jean-François Lambert, Anne Angelillo-Scherrer
Erschienen in:
Journal of Thrombosis and Thrombolysis
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Ausgabe 2/2011
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Excerpt
The major risk associated with the use of vitamin K antagonists (VKA) is haemorrhage, which might be severe or even life-threatening. In clinical studies where anticoagulation intensity was carefully monitored, treatment with VKA increases the risk of major bleeding by 0.3–0.5% per year when compared to controls [
1]. In randomized trials including patients with mechanical heart valves, VKA treatment was associated with a risk of major bleeding ranging between 1 and 8.3% [
1]. However, in clinical practice, the rates are less consistent [
1]. The major determinants of VKA-induced bleeding are the intensity of the anticoagulant effect, the patient characteristics, the concomitant use of drugs that interfere with hemostasis, and the length of therapy [
1]. …