A single dose of oral vitamin K effectively reverses oral anticoagulation with phenprocoumon during heart catheterisation.
OBJECTIVE
To investigate the effectiveness of a single adjusted dose of oral vitamin K to temporarily reverse oral anticoagulation with phenprocoumon (Marcoumar) for heart catheterisation.


METHODS
Patients under stable oral anticoagulation with phenprocoumon routinely scheduled for heart catheterizstion were given a single adjusted dose of oral vitamin K a day prior to the intervention. The customary anticoagulation scheme was kept unchanged with the exception of taking the double usual dose of phenprocoumon the evening after the intervention. The primary outcome was the achieved international normalised ratio (INR) immediately before the intervention. Secondary outcomes were the INR after one and four weeks, changes in phenprocoumon and coagulation factors II and VII and adverse events.


RESULTS
38 patients at a median age of 71 (63-74) years scheduled for heart catheterisation were included. The median INR changed from 2.2 (1.9-2.6) the day before to 1.5 (1.4-1.7) immediately before the intervention. An INR < or =1.5 respectively < or =1.8 was achieved in 61% and 95% of the patients. The INR values after one respectively four weeks were comparable to preintervention values. No thromboembolic or bleeding adverse events occurred during the study.


CONCLUSIONS
A single adjusted oral dose of vitamin K given a day prior to heart catheterisation combined with a doubled phenprocoumon dose on the procedure day seems to be an easy applicable, safe and effective way to temporary reverse oral anticoagulation with phenprocoumon.
Ulrich
Silvia
S
Department of Medicine, University Hospital of Zurich, Raemistrasse 100, CH-8091 Zurich, Switzerland. ulris@bluewin.ch
Debrunner
Johann
J
Stoll
Susanna
S
Rentsch
Katharina
K
Bachli
Esther B
EB
D000284:Administration, Oral; D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage / Q000037:antagonists & inhibitors*; D000933:Antifibrinolytic Agents / Q000627:therapeutic use*; D006328:Cardiac Catheterization; D005260:Female; D006801:Humans; D019934:International Normalized Ratio; D008297:Male; D008875:Middle Aged; D010644:Phenprocoumon / Q000008:administration & dosage / Q000037:antagonists & inhibitors*; D014812:Vitamin K / Q000627:therapeutic use*
D000925:Anticoagulants; D000933:Antifibrinolytic Agents; D014812:Vitamin K; D010644:Phenprocoumon