Prothrombin complex concentrate for rapid reversal of warfarin-induced anticoagulation and intracerebral hemorrhage in patients supported by a left ventricular assist device

Ayako Takahashi; Tomoko S. Kato; Noboru Oda; Kazuo Komamura; Hideaki Kanzaki; Masaki Asakura; Kazuhiko Hashimura; Kazuo Niwaya; Toshiaki Funatsu; Takeshi Nakatani; Junjiro Kobayashi; Soichiro Kitamura; Toshiaki Shishido; Shigeki Miyata; Jun C. Takahashi; Koji Iihara; Masafumi Kitakaze

doi:10.1016/S1873-9598(10)70038-7

Prothrombin complex concentrate for rapid reversal of warfarin-induced anticoagulation and intracerebral hemorrhage in patients supported by a left ventricular assist device

Ayako Takahashi, Tomoko S. Kato, Noboru Oda, Kazuo Komamura, Hideaki Kanzaki, Masaki Asakura, Kazuhiko Hashimura, Kazuo Niwaya, Toshiaki Funatsu, Takeshi Nakatani, Junjiro Kobayashi, Soichiro Kitamura, Toshiaki Shishido, Shigeki Miyata, Jun C. Takahashi, Koji Iihara, Masafumi Kitakaze

Research output: Contribution to journal › Article › peer-review

9 Citations (Scopus)

Abstract

Background Intracerebral hemorrhage (ICH) is one of the most serious complications in patients supported by a left ventricular assist device (LVAD). We evaluate the efficacy of prothrombin complex concentrate (PCC) for rapid reversal of warfarin-induced anticoagulation in this population. Methods A total of 38 consecutive ICH events in patients supported by an LVAD between 1996 and 2007 were retrospectively reviewed. Fourteen ICH events were treated with fresh frozen plasma (FFP) (Group FFP) and 24 ICH events were treated with PCC (Group PCC). The efficacy and outcome of PCC administration versus FFP were evaluated. Results The proportion of patients surviving after an ICH event was significantly smaller in Group FFP than Group PCC (35.7 vs. 75.0, p < 0.05). None of the patients in Group FFP were able to undergo heart transplantation, whereas 21.4 patients in Group PCC successfully underwent heart transplantation. Conclusion Patients on LVAD are in need for intensified anticoagulation and are at high risk of ICH; therefore, adequate use of PCC in the event of ICH could be of importance for survival and allow subsequent heart transplantation.

Original language	English
Pages (from-to)	143-147
Number of pages	5
Journal	International Journal of Gerontology
Volume	4
Issue number	3
DOIs	https://doi.org/10.1016/S1873-9598(10)70038-7
Publication status	Published - Sept 2010
Externally published	Yes

All Science Journal Classification (ASJC) codes

Geriatrics and Gerontology

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10.1016/S1873-9598(10)70038-7

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Takahashi, A., Kato, T. S., Oda, N., Komamura, K., Kanzaki, H., Asakura, M., Hashimura, K., Niwaya, K., Funatsu, T., Nakatani, T., Kobayashi, J., Kitamura, S., Shishido, T., Miyata, S., Takahashi, J. C., Iihara, K., & Kitakaze, M. (2010). Prothrombin complex concentrate for rapid reversal of warfarin-induced anticoagulation and intracerebral hemorrhage in patients supported by a left ventricular assist device. International Journal of Gerontology, 4(3), 143-147. https://doi.org/10.1016/S1873-9598(10)70038-7

Prothrombin complex concentrate for rapid reversal of warfarin-induced anticoagulation and intracerebral hemorrhage in patients supported by a left ventricular assist device. / Takahashi, Ayako; Kato, Tomoko S.; Oda, Noboru et al.

In: International Journal of Gerontology, Vol. 4, No. 3, 09.2010, p. 143-147.

Research output: Contribution to journal › Article › peer-review

Takahashi, A, Kato, TS, Oda, N, Komamura, K, Kanzaki, H, Asakura, M, Hashimura, K, Niwaya, K, Funatsu, T, Nakatani, T, Kobayashi, J, Kitamura, S, Shishido, T, Miyata, S, Takahashi, JC, Iihara, K & Kitakaze, M 2010, 'Prothrombin complex concentrate for rapid reversal of warfarin-induced anticoagulation and intracerebral hemorrhage in patients supported by a left ventricular assist device', International Journal of Gerontology, vol. 4, no. 3, pp. 143-147. https://doi.org/10.1016/S1873-9598(10)70038-7

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title = "Prothrombin complex concentrate for rapid reversal of warfarin-induced anticoagulation and intracerebral hemorrhage in patients supported by a left ventricular assist device",

abstract = "Background Intracerebral hemorrhage (ICH) is one of the most serious complications in patients supported by a left ventricular assist device (LVAD). We evaluate the efficacy of prothrombin complex concentrate (PCC) for rapid reversal of warfarin-induced anticoagulation in this population. Methods A total of 38 consecutive ICH events in patients supported by an LVAD between 1996 and 2007 were retrospectively reviewed. Fourteen ICH events were treated with fresh frozen plasma (FFP) (Group FFP) and 24 ICH events were treated with PCC (Group PCC). The efficacy and outcome of PCC administration versus FFP were evaluated. Results The proportion of patients surviving after an ICH event was significantly smaller in Group FFP than Group PCC (35.7 vs. 75.0, p < 0.05). None of the patients in Group FFP were able to undergo heart transplantation, whereas 21.4 patients in Group PCC successfully underwent heart transplantation. Conclusion Patients on LVAD are in need for intensified anticoagulation and are at high risk of ICH; therefore, adequate use of PCC in the event of ICH could be of importance for survival and allow subsequent heart transplantation.",

author = "Ayako Takahashi and Kato, {Tomoko S.} and Noboru Oda and Kazuo Komamura and Hideaki Kanzaki and Masaki Asakura and Kazuhiko Hashimura and Kazuo Niwaya and Toshiaki Funatsu and Takeshi Nakatani and Junjiro Kobayashi and Soichiro Kitamura and Toshiaki Shishido and Shigeki Miyata and Takahashi, {Jun C.} and Koji Iihara and Masafumi Kitakaze",

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doi = "10.1016/S1873-9598(10)70038-7",

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AU - Takahashi, Ayako

AU - Kato, Tomoko S.

AU - Oda, Noboru

AU - Komamura, Kazuo

AU - Kanzaki, Hideaki

AU - Asakura, Masaki

AU - Hashimura, Kazuhiko

AU - Niwaya, Kazuo

AU - Funatsu, Toshiaki

AU - Nakatani, Takeshi

AU - Kobayashi, Junjiro

AU - Kitamura, Soichiro

AU - Shishido, Toshiaki

AU - Miyata, Shigeki

AU - Takahashi, Jun C.

AU - Iihara, Koji

AU - Kitakaze, Masafumi

PY - 2010/9

Y1 - 2010/9

N2 - Background Intracerebral hemorrhage (ICH) is one of the most serious complications in patients supported by a left ventricular assist device (LVAD). We evaluate the efficacy of prothrombin complex concentrate (PCC) for rapid reversal of warfarin-induced anticoagulation in this population. Methods A total of 38 consecutive ICH events in patients supported by an LVAD between 1996 and 2007 were retrospectively reviewed. Fourteen ICH events were treated with fresh frozen plasma (FFP) (Group FFP) and 24 ICH events were treated with PCC (Group PCC). The efficacy and outcome of PCC administration versus FFP were evaluated. Results The proportion of patients surviving after an ICH event was significantly smaller in Group FFP than Group PCC (35.7 vs. 75.0, p < 0.05). None of the patients in Group FFP were able to undergo heart transplantation, whereas 21.4 patients in Group PCC successfully underwent heart transplantation. Conclusion Patients on LVAD are in need for intensified anticoagulation and are at high risk of ICH; therefore, adequate use of PCC in the event of ICH could be of importance for survival and allow subsequent heart transplantation.

AB - Background Intracerebral hemorrhage (ICH) is one of the most serious complications in patients supported by a left ventricular assist device (LVAD). We evaluate the efficacy of prothrombin complex concentrate (PCC) for rapid reversal of warfarin-induced anticoagulation in this population. Methods A total of 38 consecutive ICH events in patients supported by an LVAD between 1996 and 2007 were retrospectively reviewed. Fourteen ICH events were treated with fresh frozen plasma (FFP) (Group FFP) and 24 ICH events were treated with PCC (Group PCC). The efficacy and outcome of PCC administration versus FFP were evaluated. Results The proportion of patients surviving after an ICH event was significantly smaller in Group FFP than Group PCC (35.7 vs. 75.0, p < 0.05). None of the patients in Group FFP were able to undergo heart transplantation, whereas 21.4 patients in Group PCC successfully underwent heart transplantation. Conclusion Patients on LVAD are in need for intensified anticoagulation and are at high risk of ICH; therefore, adequate use of PCC in the event of ICH could be of importance for survival and allow subsequent heart transplantation.

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Prothrombin complex concentrate for rapid reversal of warfarin-induced anticoagulation and intracerebral hemorrhage in patients supported by a left ventricular assist device

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