In the setting of acute heparin-induced thrombocytopenia (HIT), argatroban is one of the initial anticoagulants of choice, which is eventually bridged to warfarin over a period of 5 or more days. Argatroban prolongs prothrombin time (PT) and increases international normalized ratio (INR). However, the effects of prolonged argatroban exposure on the PT and INR are not known. We describe an unusu...

Genetic variants in CYP2C9 and VKORC1 strongly affect steady-state warfarin dose. However, these variants also affect early international normalized ratio (INR) values during warfarin initiation. We examined whether CYP2C9/VKORC1 genotypes provide information about warfarin sensitivity additional to that provided by early INR responses. In 214 patients starting warfarin with INR-guided dose adj...

Background and Objectives: To evaluate the accuracy and the clinical utility of the Coaguchek XS, a portable point-of-care coagulometer, compared to standard laboratory methods in Korean patients. Subjects and Methods: We included 107 patients with atrial fibrillation on long-term oral warfarin therapy. The prothrombin time as expressed by the international normalized ratio (INR) was measured b...

BACKGROUND Genetic variants of the enzyme that metabolizes warfarin, cytochrome P-450 2C9 (CYP2C9), and of a key pharmacologic target of warfarin, vitamin K epoxide reductase (VKORC1), contribute to differences in patients' responses to various warfarin doses, but the role of these variants during initial anticoagulation is not clear. METHODS In 297 patients starting warfarin therapy, we asse...

BACKGROUND Few studies have attempted to investigate the clinical course or identify factors responsible for excessive anticoagulation in patients with heart disease. OBJECTIVES To determine the incidence of excessive anticoagulation in outpatients with heart disease treated with acenocoumarol, analyze the factors related with over-anticoagulation, and identify bleeding complications. PATIE...

The core promoters for mammalian protein-coding genes often contain a TATA box, an initiator (Inr) element, or both of these control elements. The TFIID complex is essential both for TATA activity and for the activity of a common class of Inr elements characterized by an approximate consensus sequence PyPyA+1NT/APyPy. Although the complete set of proteins required for basal TATA-mediated transc...

The core promoter compositions of mammalian protein-coding genes are highly variable; some contain TATA boxes, some contain initiator (Inr) elements, and others contain both or neither of these basal elements. The underlying reason for this heterogeneity remains a mystery, as recent studies have suggested that TATA-containing and Inr-containing core promoters direct transcription initiation by ...

Vitamin K antagonists (VKAs) are effective oral anticoagulants that are titrated to a narrow therapeutic international normalized ratio (INR) range. We reviewed published literature assessing the impact of INR stability - getting into and staying in target INR range - on outcomes including thrombotic events, major bleeding, and treatment costs, as well as key factors that impact INR stability. ...

BACKGROUND AND OBJECTIVES The number of patients treated with oral anticoagulation (OAC) is increasing and these patients are monitored by International Normalized Ratio (INR). Bleeding complications are common and we speculate if this is related to the limitation of INR only reflecting the initiation steps of the haemostatic process. The objective of the present review was to reassess the evid...

OBJECTIVE To present the case of warfarin-cloxacillin interaction that resulted in an increased international normalized ratio (INR). CASE SUMMARY A 70-year-old man had been treated with warfarin for atrial fibrillation. He was hospitalized because of superficial thrombophlebitis of the left median cubital vein, which developed after venipuncture. An antibiotic therapy with cloxacillin was in...