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Vitamin K therapy for managing supratherapeutic warfarin administration was argued to be evaluated using flawed methodology and an unvalidated preparation in a recent trial.
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This letter to the editor critiques a recent randomized trial on vitamin K for warfarin reversal, highlighting concerns about the specific vitamin K preparation used.
Letters15 September 2009Vitamin K to Correct OveranticoagulationMark W. Swaim, MD, PhD and B. Gail MacikMark W. Swaim, MD, PhDFrom Regional Hospital of Jackson, Jackson, TN 38305.Search for more papers by this author and B. Gail MacikFrom Regional Hospital of Jackson, Jackson, TN 38305.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-151-6-200909150-00016 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:In their recent study on managing supratherapeutic warfarin administration with or without vitamin K, Crowther and colleagues (1) use flawed methodology to arrive at what may be an apocryphal conclusion, which is that vitamin K therapy has no role in managing patients with high international normalized ratios (INRs).The study uses a commercially unavailable vitamin K preparation. The pharmacokinetics and effectiveness of this preparation have not been clinically validated.Confronted with overanticoagulation, clinicians explore recent relevant events; exclude patient dosing errors; consider vitamin K; and most important, modify doses of warfarin. Crowther and colleagues attempt to control ...References1. Crowther MA, Ageno W, Garcia D, Wang L, Witt DM, Clark NP, et al. Oral vitamin K versus placebo to correct excessive anticoagulation in patients receiving warfarin: a randomized trial. Ann Intern Med. 2009;150:293-300. [PMID: 19258557] LinkGoogle Scholar2. Groopman J, Hartzband P. Meld intuition with deliberation to sidestep diagnostic trap. ACP Internist. 2009;29:5. Google Scholar Author, Article, and Disclosure InformationAuthors: Mark W. Swaim, MD, PhD; B. Gail MacikAffiliations: From Regional Hospital of Jackson, Jackson, TN 38305.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoOral Vitamin K Versus Placebo to Correct Excessive Anticoagulation in Patients Receiving Warfarin Mark A. Crowther , Walter Ageno , David Garcia , Luqi Wang , Dan M. Witt , Nathan P. Clark , Mark D. Blostein , Susan R. Kahn , Sara K. Vesely , Sam Schulman , Michael J. Kovacs , Marc A. Rodger , Phillip Wells , David Anderson , Jeffery Ginsberg , Rita Selby , Sergio Siragusa , Mauro Silingardi , Mary Beth Dowd , and Clive Kearon Vitamin K to Correct Overanticoagulation Vittorio Pengo , Gentian Denas , and Seena Padayattil Jose Vitamin K to Correct Overanticoagulation Robert C. Pendleton and Sara Vazquez Vitamin K to Correct Overanticoagulation Ayad Jindeel Vitamin K to Correct Overanticoagulation P. Dileep Kumar Vitamin K to Correct Overanticoagulation Mark A. Crowther and David Garcia Metrics Cited byPotential antidotes for reversal of old and new oral anticoagulantsGuidelines on oral anticoagulation with warfarin - fourth edition 15 September 2009Volume 151, Issue 6Page: 432-433KeywordsConflicts of interestDecision makingHemorrhageInternational normalized ratioPharmacokineticsVitamin K ePublished: 15 September 2009 Issue Published: 15 September 2009 Copyright & PermissionsCopyright © 2009 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
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Mark W. Swaim (2009) conducted a letter in Overanticoagulation. Vitamin K was evaluated. Vitamin K therapy for managing supratherapeutic warfarin administration was argued to be evaluated using flawed methodology and an unvalidated preparation in a recent trial.
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