Neurocritical Care

, Volume 8, Issue 1, pp 36–41 | Cite as

Effectiveness of Factor IX Complex Concentrate in Reversing Warfarin Associated Coagulopathy for Intracerebral Hemorrhage

  • Farhan Siddiq
  • Abdul Jalil
  • Cara McDaniel
  • David G. Brock
  • Carissa C. Pineda
  • Rodney D. Bell
  • Kiwon Lee
Original Paper

Abstract

Introduction

The objective of this study is to show the effectiveness of Factor IX complex concentrate (FIXCC) for rapid reversal of an elevated International Normalized Ratio (INR) in patients with anticoagulation-associated intracerebral hemorrhage (AAICH).

Methods

We, retrospectively, analyzed the clinical data of 19 patients with the diagnosis of AAICH from January 2005 to May 2006. A comparison was made among patients treated with FFP and Vit.K [FFP-group (n = 9)] and patients treated with FIXCC in addition to FFP and Vit.K [FIXCC-group (n = 10)]. INR of 1.4 or less was taken as target.

Results

Mean INR on admission for FFP and FIXCC group was 1.84 ± 0.31 and 2.44 ± 1.48, respectively (P = 0.315). After administration of therapy, the INR was reduced from 1.84 ± 0.31 to 1.34 ± 0.08 (P < 0.05) in FFP group and 2.44 ± 1.48 to 1.34 ± 0.07 (P < 0.005) in FIXCC group. Three patients in FFP group (33%) and 8 patients in FIXCC group (80%) reached their target INR in 3–4 h after initiation of therapy (P = 0.012). Mean time taken by both FFP and FIXCC groups to reach the target INR was 8.52 ± 5.60 h and 4.25 ± 2.12 h, respectively (P < 0.05). The mean rate of INR correction was 0.06 ± 0.03 and 0.27 ± 0.25 per hour for the FFP and FIXCC group, respectively (P < 0.005). There was one death in FIX group and two in FFP group and no thrombotic complications.

Conclusion

Our data suggests that FIXCC in combination with FFP and Vit.K may result in decreased time required when compared to FFP and Vit.K alone for correction of warfarin associated coagulopathy in neurosurgical emergencies.

Keywords

Warfarin Factor IX complex concentrate International Normalized Ratio Intracerebral hemorrhage Profilnine SD® Prothrombin complex concentrate 

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Copyright information

© Humana Press Inc. 2007

Authors and Affiliations

  • Farhan Siddiq
    • 1
  • Abdul Jalil
    • 1
  • Cara McDaniel
    • 1
  • David G. Brock
    • 1
  • Carissa C. Pineda
    • 1
  • Rodney D. Bell
    • 1
  • Kiwon Lee
    • 2
  1. 1.Department of NeurologyThomas Jefferson UniversityPhiladelphiaUSA
  2. 2.Neurology and Neurological Surgery, Critical Care Division, Neurological InstituteColumbia University College of Physicians and Surgeons, New York Presbyterian – Columbia University Medical CenterNew YorkUSA

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