Key result
Low-dose recombinant Factor VIIa reversed warfarin anticoagulation to a goal INR of 1.5 or less in 71.9% of patients compared to 33.8% of patients receiving 3-factor prothrombin complex concentrate (p=0.001).
Why the study?
Does low-dose recombinant Factor VIIa improve achievement of INR <= 1.5 compared to 3-factor prothrombin complex concentrate in patients requiring emergent warfarin reversal?
Population
106 patients requiring emergent reversal of warfarin anticoagulation with a pre-reversal INR of 1.6 or…
Comparison
Low-dose recombinant Factor VIIa 1000 or 1200 mcg vs 3-factor prothrombin complex concentrate 20…
Design
Cohort
Follow-up
hospitalization (median 7.5-8.0 days)
Authors
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Low-dose rFVIIa was associated with higher INR reversal rates; should not yet change practice pending randomized trials.
Cohort (n=106)
No
Does low-dose recombinant Factor VIIa improve achievement of INR <= 1.5 compared to 3-factor prothrombin complex concentrate in patients requiring emergent warfarin reversal?
Absolute Event Rate: 71.9% vs 33.8%
p-value: p=0.001
Low-dose recombinant Factor VIIa was more effective than 3-factor prothrombin complex concentrate at achieving a goal INR of 1.5 or less for emergent warfarin reversal, with similar rates of thromboembolic events.
Chapman et al. (2014) conducted a cohort in Warfarin anticoagulation reversal for emergent bleeding (n=106). Low-dose recombinant Factor VIIa (LDrFVIIa) vs. 3-factor prothrombin complex concentrate (PCC3) 20 units/kg was evaluated on Achievement of an INR 1.5 or less (p=0.001). Low-dose recombinant Factor VIIa reversed warfarin anticoagulation to a goal INR of 1.5 or less in 71.9% of patients compared to 33.8% of patients receiving 3-factor prothrombin complex concentrate (p=0.001).
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