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Indications for Using an Alternative Method to the PT or INR for Monitoring Warfarin Therapy in a Patient with a Lupus Anticoagulant

Purpose:

To identify a patient with a lupus anticoagulant whose oral anticoagulation therapy should be monitored by an alternative method to the PT and INR.

Specialty:

Cardiovascular Diseases, Vascular Medicine, Clinical Pharmacology, Pharmaceutical Medicine

Objective:

laboratory tests, failure handling and therapy escalation

ICD-10:

I74, I81, I82, M32, O88

Description:

Moll and Ortel identified problems with the use of the prothrombin time (PT) and International Normalized Ratio (INR) for monitoring warfarin therapy in a patient with a lupus anticoagulant. Warfarin therapy in these patients should be monitored with an alternative method, since the PT may be unreliable. The authors are from Duke University.

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