PMID- 21252577
OWN - NLM
STAT- MEDLINE
DCOM- 20110509
LR  - 20131121
IS  - 1423-0151 (Electronic)
IS  - 1011-7571 (Linking)
VI  - 20
IP  - 2
DP  - 2011
TI  - Effect of early or delayed administration of warfarin with heparin on thrombosis 
      in pulmonary thromboembolism.
PG  - 181-6
LID - 10.1159/000319767 [doi]
AB  - OBJECTIVE: The aim of this study was to investigate the effect of early or 
      delayed warfarin administration with unfractionated heparin (UFH) on coagulation 
      parameters in pulmonary thromboembolism (PTE). PATIENTS AND METHODS: This study 
      was performed between November 2006 and July 2007. Thirty-three patients with PTE 
      were sequentially slotted to early (n = 16) and delayed (n = 17) warfarin 
      treatment groups. In the early group, both UFH infusion and warfarin were started 
      simultaneously and in the delayed group, warfarin was added (1-3 days later) 
      based on when partial thromboplastin time reached the therapeutic level with UFH. 
      The proteins C and S, D-dimer, hematocrit levels, and platelet counts for all 
      patients were studied prior to treatment and 6, 24, and 48 h after warfarin 
      treatment. In order to determine the overall effect of early and delayed warfarin 
      treatment on clot formation, a thromboelastogram was performed simultaneously. 
      RESULTS: In both groups, a similar chronological decrease in protein C levels 
      reaching maximum at 24 h with warfarin treatment was observed. However, 
      intragroup or intergroup decreases in protein S levels were not different. On 
      thromboelastogram, INTEM and EXTEM clotting times were significantly prolonged 
      chronologically, but this prolongation was not different between groups. 
      CONCLUSION: The suppressor effect of warfarin on proteins C and S in the early 
      period of double anticoagulant treatment did not appear to aggravate the risk of 
      thrombosis in patients with PTE in whom warfarin was started simultaneously with 
      UFH.
CI  - Copyright (c) 2011 S. Karger AG, Basel.
FAU - Ozlu, Tevfik
AU  - Ozlu T
AD  - Department of Chest Diseases, School of Medicine, Karadeniz Technical University, 
      Trabzon, Turkey.
FAU - Aycicek, Olcay
AU  - Aycicek O
FAU - Sonmez, Mehmet
AU  - Sonmez M
FAU - Bulbul, Yilmaz
AU  - Bulbul Y
FAU - Omay, Serdar Bedii
AU  - Omay SB
FAU - Oztuna, Funda
AU  - Oztuna F
FAU - Durmus, Ahmet
AU  - Durmus A
LA  - eng
PT  - Journal Article
DEP - 20110120
PL  - Switzerland
TA  - Med Princ Pract
JT  - Medical principles and practice : international journal of the Kuwait University, 
      Health Science Centre
JID - 8901334
RN  - 0 (Anticoagulants)
RN  - 0 (Fibrin Fibrinogen Degradation Products)
RN  - 0 (Protein C)
RN  - 0 (Protein S)
RN  - 0 (fibrin fragment D)
RN  - 5Q7ZVV76EI (Warfarin)
SB  - IM
MH  - Aged
MH  - Anticoagulants/administration & dosage/*therapeutic use
MH  - Female
MH  - Fibrin Fibrinogen Degradation Products
MH  - Hematocrit
MH  - Humans
MH  - Length of Stay
MH  - Male
MH  - Partial Thromboplastin Time
MH  - Platelet Count
MH  - Protein C
MH  - Protein S
MH  - Pulmonary Embolism/*drug therapy
MH  - Risk Factors
MH  - Statistics, Nonparametric
MH  - Thrombelastography
MH  - Time Factors
MH  - Warfarin/administration & dosage/*therapeutic use
EDAT- 2011/01/22 06:00
MHDA- 2011/05/10 06:00
CRDT- 2011/01/22 06:00
PHST- 2009/06/03 00:00 [received]
PHST- 2010/04/27 00:00 [accepted]
PHST- 2011/01/22 06:00 [entrez]
PHST- 2011/01/22 06:00 [pubmed]
PHST- 2011/05/10 06:00 [medline]
AID - 000319767 [pii]
AID - 10.1159/000319767 [doi]
PST - ppublish
SO  - Med Princ Pract. 2011;20(2):181-6. doi: 10.1159/000319767. Epub 2011 Jan 20.