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Therapeutics
A 10 mg nomogram was more effective than a 5 mg nomogram for warfarin induction in outpatient venous thromboembolism

https://doi.org/10.1136/ebm.8.6.173

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    (2003) Ann Intern Med 138, 714. Kovacs MJ, Rodger M, Anderson DR, et al.. Comparison of 10-mg and 5-mg warfarin initiation nomograms together with low-molecular-weight heparin for outpatient treatment of acute venous thromboembolism. A randomized, double-blind, controlled trial.. ;. :. –9.
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 QUESTION: In outpatients with acute venous thromboembolism (VTE), is warfarin induction with a 10 mg nomogram more effective than with a 5 mg nomogram?

    Design

    Randomised (allocation concealed*), blinded (clinicians, patients, and outcome assessors),* controlled trial with 90 day follow up.

    Setting

    4 Canadian academic centres.

    Patients

    201 patients who were ≥18 years of age (mean age 55 y, 56% men) and had objectively confirmed acute VTE (deep venous thrombosis or pulmonary embolism). Exclusion criteria were a baseline international normalized ratio (INR) >1.4, platelet count <50 × 109 cells/ml, need for hospital admission, use of oral anticoagulant therapy in the previous 2 weeks, or high risk of major bleeding. 90 day follow up was complete.

    Intervention

    Patients were allocated …

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    Footnotes

    • Source of funding: no external funding.

    • For correspondence: Dr M J Kovacs, London Health Sciences Centre, London, Ontario, Canada. michael.kovacs{at}lhsc.on.ca

    • Abstract and commentary also appear in ACP Journal Club.

    • ↵* See glossary.