Comparison of 3-Factor Prothrombin Complex Concentrate and Low-Dose Recombinant Factor VIIa for Warfarin Reversal

Prothrombin complex concentrate (PCC) and recombinant Factor VIIa (rFVIIa) have been used for emergent reversal of warfarin anticoagulation. Few clinical studies have compared these agents in warfarin reversal. We compared warfarin reversal in patients who received either 3 factor PCC (PCC3) or low-...

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Bibliographic Details
Published in:World journal of emergency surgery 2014-04, Vol.9 (1), p.27-27, Article 27
Main Authors: Chapman, Scott A, Irwin, Eric D, Abou-Karam, Nada M, Rupnow, Nichole M, Hutson, Katherine E, Vespa, Jeffrey, Roach, Robert M
Format: Article
Language:English
Subjects:
Anticoagulants
Cardiac arrhythmia
Comparative analysis
Health aspects
Hospitals
Medical records
Medical research
Medicine, Experimental
Mortality
Patients
Pharmaceutical sciences
Pharmacy
Statistical analysis
Studies
Thrombosis
Trauma
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Summary:Prothrombin complex concentrate (PCC) and recombinant Factor VIIa (rFVIIa) have been used for emergent reversal of warfarin anticoagulation. Few clinical studies have compared these agents in warfarin reversal. We compared warfarin reversal in patients who received either 3 factor PCC (PCC3) or low-dose rFVIIa (LDrFVIIa) for reversal of warfarin anticoagulation. Data were collected from medical charts of patients who received at least one dose of PCC3 (20 units/kg) or LDrFVIIa (1000 or 1200 mcg) for emergent warfarin reversal from August 2007 to October 2011. The primary end-points were achievement of an INR 1.5 or less for efficacy and thromboembolic events for safety. Seventy-four PCC3 and 32 LDrFVIIa patients were analyzed. Baseline demographics, reason for warfarin reversal, and initial INR were equivalent. There was no difference in the use of vitamin K or fresh frozen plasma. More LDrFVIIa patients achieved an INR of 1.5 or less (71.9% vs. 33.8%, p =0.001). The follow-up INR was lower after LDrFVIIa (1.25 vs. 1.75, p 
ISSN:1749-7922
1749-7922
DOI:10.1186/1749-7922-9-27