The accuracy of the International Normalized Ratio and the American College of Chest Physicians recommendations on the use of vitamin K to reverse over-anticoagulation: a reply.
J Thromb Haemost. 2012 Dec 29;
Authors: Schulman S, Crowther M, Holbrook A
The comment of Tripodi and Moia regarding the inaccuracy of the international normalized ratio (INR) above 4.5 is correct, since calibration of thromboplastin is performed with plasmas from patients with mostly adequate anticoagulation (INR 1.5 to 4.5) . They are concerned that our suggestion in the latest edition of the American College of Chest Physician (ACCP) clinical practice guidelines regarding reversal of asymptomatic high INR with vitamin K is misleading . The basis for our suggestion to abstain from reversal with vitamin K of asymptomatic INRs between 4.5 and 10 is derived from four randomized controlled trials [3-6]. © 2012 International Society on Thrombosis and Haemostasis.
PMID: 23279332 [PubMed - as supplied by publisher]