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Vitamin K Not Associated with Fewer Bleeding Events in Patients Taking Warfarin
Low-dose vitamin K may not reduce bleeding events in patients receiving anticoagulant therapy, according to a study in Annals of Internal Medicine.
Some 700 nonbleeding patients who were receiving warfarin therapy and had elevated international normalized ratios (4.5–10.0) were randomized to oral vitamin K (1.25 mg) or placebo. Warfarin was stopped the day before randomization and was resumed once the INR reached the target range (2.0–3.5).
The day after the treatment was administered, the average INR decreased significantly more in the vitamin K group compared with the control group (–2.8 vs. –1.4 INR units). However, after 90 days' follow-up, the frequency of bleeding events, thromboembolism, or death did not differ significantly between the groups.
The authors conclude that their results "support the practice of ... simple warfarin therapy withdrawal."
(The latest American College of Chest Physicians guidelines suggest "omitting the next one or two doses" of anticoagulant in patients with INRs between 5.0 and <9.0 and not at increased bleeding risk — or "alternatively" using oral vitamin K, particularly in high-risk patients. For those with INRs of 9.0 or greater and no significant bleeding, vitamin K is recommended.)
Annals of Internal Medicine
Low-dose vitamin K may not reduce bleeding events in patients receiving anticoagulant therapy, according to a study in Annals of Internal Medicine.
Some 700 nonbleeding patients who were receiving warfarin therapy and had elevated international normalized ratios (4.5–10.0) were randomized to oral vitamin K (1.25 mg) or placebo. Warfarin was stopped the day before randomization and was resumed once the INR reached the target range (2.0–3.5).
The day after the treatment was administered, the average INR decreased significantly more in the vitamin K group compared with the control group (–2.8 vs. –1.4 INR units). However, after 90 days' follow-up, the frequency of bleeding events, thromboembolism, or death did not differ significantly between the groups.
The authors conclude that their results "support the practice of ... simple warfarin therapy withdrawal."
(The latest American College of Chest Physicians guidelines suggest "omitting the next one or two doses" of anticoagulant in patients with INRs between 5.0 and <9.0 and not at increased bleeding risk — or "alternatively" using oral vitamin K, particularly in high-risk patients. For those with INRs of 9.0 or greater and no significant bleeding, vitamin K is recommended.)
Annals of Internal Medicine
