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The effects of warfarin on coagulation persist for several days after the drug is discontinued, complicating urgent surgery or invasive procedures. Attempts at rapidly restoring adequate hemostasis by administering vitamin K and clotting-factor concentrates have given mixed results.
Investigators have now conducted an industry-sponsored, phase IIIb, multicenter, open-label, randomized trial comparing a four-factor prothrombin complex concentrate (PCC; prothrombin, VII, IX, and X) with fresh-frozen plasma (FFP) in 168 warfarin-treated patients with an international normalized ratio (INR) ≥2. All participants received vitamin K preoperatively.
Patients receiving PCC versus FFP:
Had a shorter median time to surgery (3.6 vs. 8.5 hours; P=0.01).
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