Why the study?
Does dual treatment with LMWH and VKA increase the inhibition of thrombin generation compared to VKA alone at equal INR levels?
Does dual treatment with LMWH and VKA increase the inhibition of thrombin generation compared to VKA alone at equal INR levels?
Dual therapy with LMWH and VKA produces a significantly stronger anticoagulant effect (measured by thrombin generation) than VKA alone at the same INR, highlighting a potentially greater hypo-coagulation state during the bridging phase.
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May warrant caution during LMWH-VKA bridging at INR 2-3; leaves open whether thrombin generation should guide adjusted protocols.
Gerotziafas et al. (2009) studied this question.
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