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Practical application of the 10-mg warfarin initiation nomogram.

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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https://hal.univ-brest.fr/hal-00683253
Contributor : Ghislaine Calvez <>
Submitted on : Wednesday, March 28, 2012 - 11:31:00 AM
Last modification on : Thursday, February 7, 2019 - 2:50:04 PM

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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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