Low-dose vitamin k(1) versus short-term withholding of acenocoumarol in the treatment of excessive anticoagulation episodes induced by acenocoumarol - A retrospective comparative study

Background: No consensus exists about the management of iatrogenically indu ced excessive hypocoagulability episodes, Objective: To compare the two mos t common therapeutic approaches in such situations (discontinuation of the oral anticoagulant vs. low-dose subcutaneous vitamin K-1) when acenocoumaro l is the normally used anticoagulant. Patients and Methods: The study was r etrospective and comparative. Patients received antithrombotic therapy usin g acenocoumarol. Anticoagulant plasmatic activity was assessed through the international normalized ratio (INR) recorded from December 1994 to Decembe r 1997 at two medical centers. Results: INR is brought faster to a safe ran ge in patients treated with low-dose vitamin K-1 (p = 0.01). Their long-ter m behavior is also more stable and predictable and no resistance to the ora l anticoagulant was found. Conclusion: Low-dose vitamin K-1 is a safer ther apeutic option compared to simply withholding the oral anticoagulant. Its b est scheme of administration, however, has yet to be defined.