Practical application of the 10-mg warfarin initiation nomogram.

Philip S Wells 1, 2 Grégoire Le Gal 3 Sarah Tierney Marc Carrier 4, 5
1 Clinical Epidemiology Unit
2 Thrombosis Program
3 GETBO - Groupe d'Etude de la Thrombose de Bretagne Occidentale
4 Clinical Epidemiology Unit
5 Thrombosis Program
Abstract : Initiation of warfarin therapy is a clinical challenge. A 10-mg warfarin initiation nomogram was recently validated in a randomized controlled trial. We sought to determine the efficacy and safety of this 10-mg warfarin initiation nomogram in 'real-life' daily practice. A retrospective cohort including all outpatients beginning concurrent treatment with warfarin and low-molecular-weight heparin over a 24-month period in our Thrombosis Unit was reviewed. Eight hundred and forty-one patients were included; of them, 640 (76.1%) were started on the nomogram. The nomogram was entirely followed in 324 patients (38.5%). The efficacy and safety profile was similar to that observed in the original clinical trial; 86% of patients managed according to the nomogram reached the international normalized ratio target of 2.0-3.0 within 5 days. Mean duration of low-molecular-weight heparin treatment was 6.0 +/- 1.9 days, and 3.7% of patients had an international normalized ratio of at least 5.0 in the first 4 weeks of treatment. The 10-mg nomogram effectively results in an early therapeutic international normalized ratio with a good safety profile in 'real-life' daily practice.
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Article dans une revue
Blood Coagulation and Fibrinolysis, Lippincott, Williams & Wilkins, 2009, 20 (6), pp.403-8. 〈10.1097/MBC.0b013e32832b184d〉
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http://hal.univ-brest.fr/hal-00683253
Contributeur : Ghislaine Calvez <>
Soumis le : mercredi 28 mars 2012 - 11:31:00
Dernière modification le : mercredi 10 janvier 2018 - 14:42:02

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GETBO | UNIV-BREST

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Philip S Wells, Grégoire Le Gal, Sarah Tierney, Marc Carrier. Practical application of the 10-mg warfarin initiation nomogram.. Blood Coagulation and Fibrinolysis, Lippincott, Williams & Wilkins, 2009, 20 (6), pp.403-8. 〈10.1097/MBC.0b013e32832b184d〉. 〈hal-00683253〉

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