Relationship between elevated bilirubin levels and enhanced warfarin effects during biliary obstruction

Objectives A marked prolongation of the prothrombin time-international normalized ratio (PT-INR) is frequently observed during biliary obstruction in patients using warfarin. The objective of this study was to identify factors associated with PT-INR prolongation during biliary obstruction in patient...

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Published in:European journal of clinical pharmacology 2023-03, Vol.79 (3), p.437-443
Main Authors: Nakazawa, Takafumi, Yamazaki, Shingo, Uchida, Masashi, Suzuki, Takaaki, Nakamura, Takako, Ohtsuka, Masayuki, Ishii, Itsuko
Format: Article
Language:English
Subjects:
Anticoagulants - therapeutic use
Bilirubin
Biomedical and Life Sciences
Biomedicine
Blood Coagulation Disorders
Humans
International Normalized Ratio
Laboratories
Pharmacology/Toxicology
Prothrombin
Prothrombin Time
Retrospective Studies
Warfarin
Warfarin - therapeutic use
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Summary:Objectives A marked prolongation of the prothrombin time-international normalized ratio (PT-INR) is frequently observed during biliary obstruction in patients using warfarin. The objective of this study was to identify factors associated with PT-INR prolongation during biliary obstruction in patients using warfarin. Methods Among 44 patients using warfarin who had biliary obstruction, we retrospectively investigated warfarin doses and laboratory data before and during biliary obstruction. The primary outcome was the association between changes in PT-INR (ΔPT-INR) and changes in laboratory data before and during biliary obstruction. Results Median PT-INR was 1.59 (IQR 1.38–1.95) before biliary obstruction and 2.27 (IQR 1.60–3.49) during biliary obstruction, indicating significant prolongation during the obstruction ( P  
ISSN:0031-6970
1432-1041
DOI:10.1007/s00228-023-03459-7