Warfarin: Less May Be Better

Letters15 August 1997Warfarin: Less May Be BetterPaul R. Casner, MD, PhDPaul R. Casner, MD, PhDTexas Tech University Health Sciences Center; El Paso, TX 79905Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-127-4-199708150-00017 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:In their report on loading doses of warfarin therapy, Harrison and colleagues [1] concluded that a 5-mg loading dose of warfarin produced less excess anticoagulation than a 10-mg loading dose. The authors base this conclusion on the fact that fewer patients in the 5-mg group than in the 10-mg group had an INR greater than 3.0. Because the specific values of the greater-than-3.0 INRs are not given, we do not know whether these elevations are clinically significant. For example, INRs of 3.1, 3.2, or 3.3 could be classified as “excess anticoagulation,” but these elevations are not clinically ...References1. Harrison L, Johnston M, Massicotte MP, Crowther M, Moffat K, Hirsh J. Comparison of 5-mg and 10-mg loading doses in initiation of warfarin therapy. Ann Intern Med. 1997; 126:133-6. Google Scholar2. Hirsh J, Dalen JE, Deykin D, Poller L, Bussey H. Oral anticoagulants: mechanism of action, clinical effectiveness. and optimal therapeutic range. Chest. 1995; 108(4 Suppl):231S-46S. Google Scholar Author, Article, and Disclosure InformationAffiliations: Texas Tech University Health Sciences Center; El Paso, TX 79905 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByReliability of Point-of-Care International Normalized Ratio Testing in an Academic Family Medicine ClinicCost Effectiveness of Genotype-Guided Warfarin Dosing in Patients with Mechanical Heart Valve Replacement Under the Fee-for-Service System 15 August 1997Volume 127, Issue 4Page: 332KeywordsInternational normalized ratioVitamin K Issue Published: 15 August 1997 CopyrightCopyright © 1997 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...