Superiority of Prothrombin Complex Concentrate versus Frozen Fresh Plasma in Cardiology Patients with Warfarin Intoxication–Observational Study

• 作者: Alexandre de Matos Soeiro Aline Siqueira Bossa Bruno Biselli Carlos V. Serrano Ludhmila Abraã Maria Carolina Feres de Almeida Soeiro Maria Cristina César Múcio Tavares Oliveira o Hajjar T. de Carvalho Andreucci Torres Leal
• 来源期刊: 急诊医学(英文)
• 学科: 医学
• 关键词: INTOXICATION WARFARIN Fresh FROZEN Plasma PROTHROMBIN Complex Concentrate
• 年，卷（期）: 2017,（2）
• 页码范围: 75-84
• 页数: 10页
• 分类号: R73

摘要

Objective: The objective of this study was to analyse the reversibility of the anticoagulant effect of warfarin by comparing prothrombin complex concentrate (PCC) versus frozen fresh plasma (FFP) in cardiology patients with serious warfarin intoxication. Methods: This was an observational and retrospective study comprising 67 patients (18 in group I [PCC] and 49 in group II [FFP]). The primary endpoint was the reversal of anticoagulant effect of warfarin after 2 and 24 hours of PCC or FFP administration. Comparisons between the groups were made using T-test and Q-square. Multivariate analyses were conducted using logistic regression, and the results were considered significant when p Results: The medium dose used was 27.6 UI/kg of PCC and 14.5 ml/kg of FFP. Significant differences were observed between groups I and II in the INR reversibility measurements after 2 hours (33.3% vs. 6.1%, p = 0.001) and 24 hours (38.9% vs. 12.2%, p = 0.009) as well as in the occurrence of pulmonary edema (5.6% vs. 42.9%, OR = 11.10, p = 0.04). The AUC for PCC was 0.891 (CI 95% [0.72 - 1.0]), and for FFP, it was 0.291 (CI 95% [0.09 - 0.49]). Conclusions: PCC is better than FFP treatment in reversing the warfarin intoxication after 2 and 24 hours of administration. Furthermore, PCC showed lower pulmonary edema in cardiology patients.