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The Effect of Preoperative Vitamin K on the INR in Bridging Therapy

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Abstract

We investigated a bridging protocol using oral Vitamin K three days before scheduled surgery. 60 patients in two bridging protocols, 30 cases per protocol. The first cohort (Control group) had its warfarin held on Day-5 (five days before surgery). The intervention cohort (Vitamin K group) routinely received 2.5 mg of oral Vitamin K on Day-3 but was otherwise identically bridged. Primary outcome was INR on Day-1. Secondary outcomes included patients with INRs ≥1.5 on Day-1, bleeding episodes and elevated INR post surgery. Day-1 INR for the Vitamin K group was 1.16, vs. 1.28 for the Control group (p = 0.037). Postoperative INR was similar. Only the Control group had patients with INRs ≥1.5 on Day-1, or patients with significant bleeding. Adding Vitamin K on Day-3 leads to a safe preoperative INR and may limit other complications.

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Conflict of interest

There are no conflicts of interest to report for any of the authors.

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Authors and Affiliations

  1. Department of Medicine, Winthrop-University Hospital, Mineola, NY, USA

    Ashrei Bayewitz

  2. Medicine, Hospital for Special Surgery, New York, NY, USA

    Barbara Scorziello

  3. Department of Medicine, Montefiore Medical Center, Bronx, NY, USA

    Clarice Maala & Emily Giannattasio

  4. Division of Hematology, Department of Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA

    Henny Heisler Billett

Authors
  1. Ashrei Bayewitz
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  2. Barbara Scorziello
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  3. Clarice Maala
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  4. Emily Giannattasio
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  5. Henny Heisler Billett
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Corresponding author

Correspondence to Henny Heisler Billett.

Additional information

Source of support: Albert Einstein College of Medicine Senior Research Fellowship, 2012. All authors had access to the data and a role in writing the manuscript.

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Bayewitz, A., Scorziello, B., Maala, C. et al. The Effect of Preoperative Vitamin K on the INR in Bridging Therapy. Int J Hematol 101, 264–267 (2015). https://doi.org/10.1007/s12185-015-1744-x

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  • DOI: https://doi.org/10.1007/s12185-015-1744-x

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