Optimal Therapeutic Range for Oral Anticoagulants
CHEST JournalPublished 1 February 1989
Jack Hirsh, L. Poller, Daniel Deykin, Mark N. Levine, James E. Dalen
Citations153
SJR quartileQ1
SJR score1.83
SNIP1.83
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Abstract
The optimal therapeutic range for oral anticoagulant therapy was reviewed by the Committee on Antithrombotic Therapy of the American College of Chest Physicians (ACCP) and the National Heart, Lung and Blood Institute (NHLBI) at their first conference. Their recommendation that the intensity of warfarin treatment should be reduced for many conditions1,2 was based on the results of randomized clinical trials.
Keywords
Medicine
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735 Citations1982R. Hull, J. Hirsh +10 more
It is indicated that less intense anticoagulant therapy is associated with a low frequency of recurrent venous thromboembolism and a reduced risk of hemorrhage.
New England Journal of MedicineWarfarin Sodium versus Low-Dose Heparin in the Long-Term Treatment of Venous Thrombosis
609 Citations1979Russell D. Hull, Terry Delmore +6 more
Adjust-dose warfarin sodium is more effective than low-dose subcutaneous heparin in preventing recurrent venous thromboembolism, but its use is accompanied by a significant risk of bleeding.
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449 Citations1969C Bjerkelund, Otto M. Orning
Prophylactic anticoagulant therapy is clearly indicated before and after attempts to convert atrial fibrillation in patients with a history of previous embolic episodes, and should preferably be given in connection with attempts at conversion in all cases.
New England Journal of MedicineAdjusted Subcutaneous Heparin versus Warfarin Sodium in the Long-Term Treatment of Venous Thrombosis
444 Citations1982Russell D. Hull, Terry Delmore +6 more
The LancetRANDOMISED COMPARISON OF TWO INTENSITIES OF ORAL ANTICOAGULANT THERAPY AFTER TISSUE HEART VALVE REPLACEMENT
317 Citations1988A. G. G. Turpie, Jack Hirsh +3 more
The less intensive regimen is no less effective and safer than standard anticoagulant therapy in patients with tissue heart valve replacement and Haemorrhagic complications were significantly more frequent with standard treatment than with the lessintensive regimen.
Thrombosis and HaemostasisCalibration of Reference Thromboplastins and Standardisation of the Prothrombin Time Ratio
298 Citations1983Thomas B. L. Kirkwood
The revised model, which retains fundamentally the same principle for standardising prothrombin time tests, has proved suitable for calibrating thromboplastins of different species and types and, moreover, has certain statistical advantages over its predecessor.
JAMATwo-Step Warfarin Therapy
244 Citations1983Charles W. Francis
This study demonstrates that two-step warfarin therapy provides highly effective prophylaxis of postoperative venous thrombosis after elective hip or knee prosthetic surgery without excessive risk of perioperative bleeding.
BMJAssessment of Short-term Anticoagulant Administration after Cardiac Infarction
192 Citations1969
There was a significant reduction in the frequency of clinically evident thromboembolic complications among patients in the high-dosage group and this did not, however, materially affect the difference in mortality from all causes.
BMJFixed minidose warfarin: a new approach to prophylaxis against venous thrombosis after major surgery.
172 Citations1987L. Poller, Angela McKernan +4 more
The lack of disturbance of normal haemostasis at the time of operation together with a significant reduction in deep vein thrombosis may encourage surgeons to introduce minidose prophylaxis with warfarin.
BMJOral anticoagulants controlled by the British comparative thromboplastin versus low-dose heparin in prophylaxis of deep vein thrombosis
156 Citations1978D A Taberner, L. Poller +2 more
The study showed that oral anticoagulant prophylaxis stabilised preoperatively and low-dose heparin were equally effective in preventing deep vein thrombosis in a moderate-risk group.
JAMAAnticoagulant therapy after acute myocardial infarction. Relation of therapeutic benefit to patient's age, sex, and severity of infarction
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JAMAAnticoagulant Therapy After Acute Myocardial Infarction
116 Citations1972Arnold Drapkin
The value of anticoagulant therapy after acute myocardial infarction has been assessed in 1,136 patients admitted to the Bronx Municipal Hospital Center, and the treatment reduced the overall mortality in women from 31% to 15%, particularly those 55 years of age or over, with moderately severe infarctions.
British Journal of HaematologyDosage and control of oral anticoagulants: an international collaborative survey
111 Citations1982L. Poller, D A Taberner
PubMedProphylaxis against central vein thrombosis with low-dose warfarin.
88 Citations1986Murray M. Bern, Albert Bothe +4 more
Low doses of warfarin that do not prolong the prothrombin time appear to offer prophylaxis against venous thrombosis in patients at high risk for developing venous Thrombi adjacent to the central venous catheters.
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60 Citations1987J. Hirsh
The proceedings of a national conference on antithrombotic therapy (anticoagulant therapy and platelet-suppressive therapy) and the recommendations of the proceedings were summarized in the Archives of Chest imply that for more than two decades many patients in North America could have been treated as effectively but more safely by using lower doses of oral anticoagULants.
Journal of Clinical PathologyEffect of international sensitivity index (ISI) of thromboplastins on precision of international normalised ratios (INR)
59 Citations1989D A Taberner, L. Poller +2 more
Manufacturers of thromboplastin should be encouraged to produce reagents showing good precision of results reported as simple prothrombin ratios and a low ISI value to avoid impairment in precision when ratio results are transformed to INR.
American Journal of Clinical PathologyStandardization of Laboratory Tests for Controlling Anticoagulant Therapy
50 Citations1970Stanley Zucker, Mary H. Cathey +2 more
This report describes a method for standardizing thromboplastin reagents by performing parallel tests on specimens from a large group of patients treated with coumarin by means of least-square regression analysis.
The American Journal of CardiologyAnticoagulant therapy after acute myocardial infarction
35 Citations1990Alexander G.G. Turpie
The study used the development of left ventricular mural thrombosis, a frequent complication of acute myocardial infarction that carries a high risk for systemic embolic complications, to assess clinical outcome and suggests that monitoring plasma heparin levels and anticoagulant response can ensure maximal treatment effectiveness.
Thrombosis and HaemostasisA Simple Nomogram for the Derivation of International Normalised Ratios for the Standardisation of Prothrombin Times
28 Citations1988L. Poller
CirculationUse of Different Tissue Thromboplastins in the Control of Anticoagulant Therapy
28 Citations1957Marc Verstraete, Patricia A. Clark +1 more
An evaluation of the dependability and significance of different types of tissue thromboplastin in the determination of effects of coumarin derivatives is presented.
British Journal of HaematologyAn Evaluation of Chromogenic Substrates in the Control of Oral Anticoagulant Therapy
27 Citations1981Z Latałło, J M Thomson +1 more
The development of a specific amidolytic assay for factor VII should be considered based on the evidence of this study although its reliability for oral anticoagulant control would need to be validated by clinical trial.
Journal of Clinical PathologySurvey of prothrombin time in National External Quality Assessment Scheme exercises (1980-87).
25 Citations1988L. Poller, D A Taberner +2 more
Performance of the other Quick test reagents had not regained the standards of precision previously achieved by the human brain reagent, and only one reagent (ISI 1.1) showed an improvement in precision when the recent results from 1986-87 were analysed.
Annals of Internal MedicineRecent Developments in Antithrombotic Therapy
19 Citations1969I. S. Wright
Thrombosis is one of the most important disease phenomena responsible for disability and death and recent studies involving the prevention and treatment of this condition are reviewed.
Thrombosis and HaemostasisUtility of a Modified Calibration Model for Reliable Conversion of Thromboplastin Times to International Normalized Ratios
19 Citations1986G.O. Gogstad, J Wadt +2 more
This is the first study in which three independent laboratories demonstrate a similar bias of the WHO calibration model and a modified model in which a correction factor is introduced was applied and proved to give a reliable calculation method for INR on Normotest.
