Bridging Low-Molecular-Weight Heparin for Temporary Interruption of Warfarin

Letters6 November 2007Bridging Low-Molecular-Weight Heparin for Temporary Interruption of WarfarinA. M. Shojania, MDA. M. Shojania, MDFrom St. Boniface General Hospital, Winnipeg, Manitoba R2H 2A6, Canada.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-147-9-200711060-00016 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:In their recent article on preoperative anticoagulant activity of low-molecular-weight heparin (LMWH) after a standardized bridging regimen, O'Donnell and colleagues (1) indicated the following: warfarin was withheld 4 to 5 days before the planned procedure; enoxaparin, 1 mg/kg of body weight twice daily, was given to patients 3 days before surgery; and the final dose of enoxaparin was given the night before surgery. They conclude that because the mean anti–factor Xa level before surgery was 0.6 U/mL and anti-Xa levels were 0.5 U/mL or greater in 68% of the patients, preoperative bridging therapy will result in a ...References1. O'Donnell MJ, Kearon C, Johnson J, Robinson M, Zondag M, Turpie I, et al. Brief communication: preoperative anticoagulant activity after bridging low-molecular-weight heparin for temporary interruption of warfarin. Ann Intern Med. 2007;146:184-7. [PMID: 17283349] LinkGoogle Scholar2. Hirsh J, Raschke R. Heparin and low-molecular-weight heparin: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest. 2004;126:188S-203S. [PMID: 15383472] CrossrefMedlineGoogle Scholar3. Shojania AM. More on: is laboratory monitoring of low-molecular-weight heparin necessary? [Letter]. J Thromb Haemost. 2004;2:2276-7. [PMID: 15613053] CrossrefMedlineGoogle Scholar4. Ferreira I, Dos L, Tornos P, Nicolau I, Permanyer-Miralda G, Soler-Soler J. Experience with enoxaparin in patients with mechanical heart valves who must withhold acenocumarol. Heart. 2003;89:527-30. [PMID: 12695457] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: A. M. Shojania, MDAffiliations: From St. Boniface General Hospital, Winnipeg, Manitoba R2H 2A6, Canada.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoBrief Communication: Preoperative Anticoagulant Activity after Bridging Low-Molecular-Weight Heparin for Temporary Interruption of Warfarin Martin J. O'Donnell , Clive Kearon , Judy Johnson , Marlene Robinson , Michelle Zondag , Irene Turpie , and Alexander G. Turpie Bridging Low-Molecular-Weight Heparin for Temporary Interruption of Warfarin Martin J. O'Donnell , Clive Kearon , and Alexander G. Turpie Metrics 6 November 2007Volume 147, Issue 9Page: 671KeywordsAnticoagulantsBody weightConflicts of interestHemorrhageHeparinInternational normalized ratioLow molecular weight heparinPathologistsSurgeryVitamin K ePublished: 6 November 2007 Issue Published: 6 November 2007 Copyright & PermissionsCopyright © 2007 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...