international normalized ratio

Summary

Summary: System established by the World Health Organization and the International Committee on Thrombosis and Hemostasis for monitoring and reporting blood coagulation tests. Under this system, results are standardized using the International Sensitivity Index for the particular test reagent/instrument combination used.

Top Publications

  1. ncbi Efficacy and safety of apixaban compared with warfarin at different levels of predicted international normalized ratio control for stroke prevention in atrial fibrillation
    Lars Wallentin
    Uppsala Clinical Research Center, Uppsala University, Dag Hammarskjolds vag 14B, Uppsala, Sweden
    Circulation 127:2166-76. 2013
  2. ncbi Efficacy and safety of dabigatran compared with warfarin at different levels of international normalised ratio control for stroke prevention in atrial fibrillation: an analysis of the RE-LY trial
    Lars Wallentin
    Uppsala Clinical Research Centre, Uppsala University, Uppsala, Sweden
    Lancet 376:975-83. 2010
  3. ncbi Benefit of oral anticoagulant over antiplatelet therapy in atrial fibrillation depends on the quality of international normalized ratio control achieved by centers and countries as measured by time in therapeutic range
    Stuart J Connolly
    Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
    Circulation 118:2029-37. 2008
  4. ncbi Self-monitoring of oral anticoagulation: systematic review and meta-analysis of individual patient data
    Carl Heneghan
    Oxford University, Department of Primary Care Health Sciences, Oxford, UK
    Lancet 379:322-34. 2012
  5. ncbi Effect of intensity of oral anticoagulation on stroke severity and mortality in atrial fibrillation
    Elaine M Hylek
    General Medicine Division, Clinical Epidemiology Unit, Massachusetts General Hospital, Harvard Medical School, Boston 02114, USA
    N Engl J Med 349:1019-26. 2003
  6. ncbi Warfarin treatment in patients with atrial fibrillation: observing outcomes associated with varying levels of INR control
    Christopher Ll Morgan
    Cardiff Research Consortium Ltd, University Hospital of Wales, Heath Park, Cardiff CF14 4UJ, UK
    Thromb Res 124:37-41. 2009
  7. pmc Evidence-based management of anticoagulant therapy: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines
    Anne Holbrook
    Division of Clinical Pharmacology and Therapeutics, Department of Medicine, McMaster University, Hamilton, ON, Canada
    Chest 141:e152S-84S. 2012
  8. ncbi Risk-adjusted percent time in therapeutic range as a quality indicator for outpatient oral anticoagulation: results of the Veterans Affairs Study to Improve Anticoagulation (VARIA)
    Adam J Rose
    Center for Health Quality, Outcomes, and Economic Research, Bedford VA Medical Center, 200 Springs Road, Bedford, MA 01730, USA
    Circ Cardiovasc Qual Outcomes 4:22-9. 2011
  9. ncbi Anticoagulation control in Sweden: reports of time in therapeutic range, major bleeding, and thrombo-embolic complications from the national quality registry AuriculA
    Mattias Wieloch
    Department of Clinical Sciences, Malmo, Lund University, Sweden
    Eur Heart J 32:2282-9. 2011
  10. ncbi The impact of CYP2C9 and VKORC1 genetic polymorphism and patient characteristics upon warfarin dose requirements: proposal for a new dosing regimen
    Elizabeth A Sconce
    School of Clinical and Laboratory Sciences, University of Newcastle, Newcastle upon Tyne, United Kingdom
    Blood 106:2329-33. 2005

Detail Information

Publications283 found, 100 shown here

  1. ncbi Efficacy and safety of apixaban compared with warfarin at different levels of predicted international normalized ratio control for stroke prevention in atrial fibrillation
    Lars Wallentin
    Uppsala Clinical Research Center, Uppsala University, Dag Hammarskjolds vag 14B, Uppsala, Sweden
    Circulation 127:2166-76. 2013
    ..We evaluated treatment effects in relation to 2 predictions of time in therapeutic range (TTR)...
  2. ncbi Efficacy and safety of dabigatran compared with warfarin at different levels of international normalised ratio control for stroke prevention in atrial fibrillation: an analysis of the RE-LY trial
    Lars Wallentin
    Uppsala Clinical Research Centre, Uppsala University, Uppsala, Sweden
    Lancet 376:975-83. 2010
    ..We aimed to investigate the primary and secondary outcomes of the RE-LY trial in relation to each centre's mean TTR (cTTR) in the warfarin population...
  3. ncbi Benefit of oral anticoagulant over antiplatelet therapy in atrial fibrillation depends on the quality of international normalized ratio control achieved by centers and countries as measured by time in therapeutic range
    Stuart J Connolly
    Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
    Circulation 118:2029-37. 2008
    ..OAC) therapy is effective in atrial fibrillation but requires vigilance to maintain the international normalized ratio in the therapeutic range...
  4. ncbi Self-monitoring of oral anticoagulation: systematic review and meta-analysis of individual patient data
    Carl Heneghan
    Oxford University, Department of Primary Care Health Sciences, Oxford, UK
    Lancet 379:322-34. 2012
    ....
  5. ncbi Effect of intensity of oral anticoagulation on stroke severity and mortality in atrial fibrillation
    Elaine M Hylek
    General Medicine Division, Clinical Epidemiology Unit, Massachusetts General Hospital, Harvard Medical School, Boston 02114, USA
    N Engl J Med 349:1019-26. 2003
    ..with atrial fibrillation is greatly reduced by oral anticoagulation, with the full effect seen at international normalized ratio (INR) values of 2.0 or greater...
  6. ncbi Warfarin treatment in patients with atrial fibrillation: observing outcomes associated with varying levels of INR control
    Christopher Ll Morgan
    Cardiff Research Consortium Ltd, University Hospital of Wales, Heath Park, Cardiff CF14 4UJ, UK
    Thromb Res 124:37-41. 2009
    ..We aimed to determine the level of INR control associated with reduced stroke and mortality...
  7. pmc Evidence-based management of anticoagulant therapy: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines
    Anne Holbrook
    Division of Clinical Pharmacology and Therapeutics, Department of Medicine, McMaster University, Hamilton, ON, Canada
    Chest 141:e152S-84S. 2012
    ..This article focuses on the common important management questions for which, at a minimum, low-quality published evidence is available to guide best practices...
  8. ncbi Risk-adjusted percent time in therapeutic range as a quality indicator for outpatient oral anticoagulation: results of the Veterans Affairs Study to Improve Anticoagulation (VARIA)
    Adam J Rose
    Center for Health Quality, Outcomes, and Economic Research, Bedford VA Medical Center, 200 Springs Road, Bedford, MA 01730, USA
    Circ Cardiovasc Qual Outcomes 4:22-9. 2011
    ..Our objective was to profile site performance in the Veterans Health Administration (VA) using risk-adjusted percent time in therapeutic range (TTR)...
  9. ncbi Anticoagulation control in Sweden: reports of time in therapeutic range, major bleeding, and thrombo-embolic complications from the national quality registry AuriculA
    Mattias Wieloch
    Department of Clinical Sciences, Malmo, Lund University, Sweden
    Eur Heart J 32:2282-9. 2011
    ..This is the first report of TTR in AuriculA and, in a subgroup of two centres, bleeding and thrombo-embolic complications during 2008...
  10. ncbi The impact of CYP2C9 and VKORC1 genetic polymorphism and patient characteristics upon warfarin dose requirements: proposal for a new dosing regimen
    Elizabeth A Sconce
    School of Clinical and Laboratory Sciences, University of Newcastle, Newcastle upon Tyne, United Kingdom
    Blood 106:2329-33. 2005
    ..Studied were 297 patients with stable anticoagulation with a target international normalized ratio (INR) of 2.0 to 3.0...
  11. ncbi Relationship between patients' warfarin knowledge and anticoagulation control
    Elaine Othilia Y L Tang
    School of Pharmacy, The Chinese University of Hong Kong, Hong Kong
    Ann Pharmacother 37:34-9. 2003
    ..To evaluate patients' knowledge of warfarin and its relationship to anticoagulation control...
  12. ncbi Use of genetic and nongenetic factors in warfarin dosing algorithms
    Alan H B Wu
    University of California, San Francisco, Department of Laboratory Medicine, Clinical Chemistry Laboratory, San Francisco General Hospital, 1001 Potrero Avenue, San Francisco, CA 94110, USA
    Pharmacogenomics 8:851-61. 2007
    ..The development of a warfarin dosing algorithm that includes genotyping may be the means to achieve this goal...
  13. ncbi Antithrombotic therapy in atrial fibrillation: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition)
    Daniel E Singer
    Clinical Epidemiology Unit, Massachusetts General Hospital, Boston, MA 02114, USA
    Chest 133:546S-592S. 2008
    ..in this chapter are the following (all vitamin K antagonist [VKA] recommendations have a target international normalized ratio [INR] of 2.5; range 2.0-3.0, unless otherwise noted)...
  14. ncbi Risks of stroke and mortality associated with suboptimal anticoagulation in atrial fibrillation patients
    A M Gallagher
    General Practice Research Database, Medicines and Healthcare products Regulatory Agency, London, UK
    Thromb Haemost 106:968-77. 2011
    ..18-0.25). Mortality rates were also significantly lower with at least 70% of time spent within therapeutic range. In conclusion, good anticoagulation control was associated with a reduction in the risk of stroke...
  15. ncbi Oral anticoagulant therapy in patients with nonrheumatic atrial fibrillation and risk of bleeding. A Multicenter Inception Cohort Study
    V Pengo
    Department of Clinical and Experimental Medicine, University of Padova, Italy
    Thromb Haemost 85:418-22. 2001
    ..Patients were kept at optimal intensity of treatment for 63% of the time. These data confirm the efficacy of OA but identify elderly patients as a high risk group of major bleeding...
  16. ncbi Pharmacokinetics and pharmacodynamics of dabigatran etexilate, an oral direct thrombin inhibitor, are not affected by moderate hepatic impairment
    Joachim Stangier
    Boehringer Ingelheim GmbH and Co KG, Birkendorferstr 69, 88397 Biberach an der Riss, Germany
    J Clin Pharmacol 48:1411-9. 2008
    ..This study shows that moderate hepatic impairment does not affect the PK/PD or safety profile of dabigatran. Therefore, patients with moderate hepatic impairment can be given dabigatran etexilate without the need for dose adjustment...
  17. pmc Genetic warfarin dosing: tables versus algorithms
    Brian S Finkelman
    Center for Clinical Epidemiology and Biostatistics, Department of Biostatistics and Epidemiology, University of Pennsylvania School of Medicine, Philadelphia, USA
    J Am Coll Cardiol 57:612-8. 2011
    ..The aim of this study was to compare the accuracy of genetic tables and formal pharmacogenetic algorithms for warfarin dosing...
  18. ncbi Results of an open-label, prospective study of anticoagulant therapy for atrial fibrillation in an outpatient anticoagulation clinic
    Ahmed H Abdelhafiz
    Department of Geriatric Medicine, Rotherham General Hospital, Rotherham, United Kingdom
    Clin Ther 26:1470-8. 2004
    ..The goal of this study was to investigate the complications and control of warfarin treatment in patients with nonvalvular atrial fibrillation (NVAF) newly referred to an outpatient anticoagulation clinic...
  19. ncbi VKORC1 and CYP2C9 genotype and patient characteristics explain a large proportion of the variability in warfarin dose requirement among children
    Tina T Biss
    Institute of Cellular Medicine, Newcastle upon Tyne, United Kingdom
    Blood 119:868-73. 2012
    ..A pharmacogenomic approach to warfarin dosing has the potential to improve the efficacy and safety of warfarin therapy in children. However, algorithms should be derived from data in children if their potential benefit is to be realized...
  20. ncbi Precision and accuracy of point-of-care testing coagulometers used for self-testing and self-management of oral anticoagulation therapy
    T D Christensen
    Department of Cardiothoracic and Vascular Surgery and Institute of Clinical Medicine, Aarhus University Hospital, Aarhus N, Denmark
    J Thromb Haemost 10:251-60. 2012
    Oral anticoagulation therapy is monitored by the use of the International Normalized Ratio (INR). Patients who perform self-testing or self-management use a point-of-care testing (POCT) coagulometer (INR monitor) to estimate their INRs...
  21. ncbi Self-monitoring and self-management of oral anticoagulation
    Josep M Garcia Alamino
    Department of Primary Health Care, University of Oxford, Old Road Campus, Old Road, Headington, Oxford, UK, OX3 7LF
    Cochrane Database Syst Rev 4:CD003839. 2010
    ..However, self-monitoring or self-management were not feasible for up to half of the patients requiring anticoagulant therapy. Reasons included patient refusal, exclusion by their general practitioner, and inability to complete training...
  22. ncbi Hemorrhagic complications of anticoagulant and thrombolytic treatment: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition)
    Sam Schulman
    McMaster Clinics, HHS General Hospital, 237 Barton Street E, Hamilton, Ontario, Canada
    Chest 133:257S-298S. 2008
    ..There is good evidence that VKA therapy, targeted international normalized ratio (INR) of 2.5 (range, 2.0-3...
  23. ncbi A prospective study of an aggressive warfarin dosing algorithm to reach and maintain INR 2 to 3 after heart valve surgery
    Karina Meijer
    Division of Haemostasis and Thrombosis, Department of Haematology, University Medical Centre Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
    Thromb Haemost 105:232-8. 2011
    ..We demonstrate an improvement of the level of anticoagulation control with the use of a condition-specific, aggressive algorithm, as compared to standard dosing, in patients after heart valve surgery...
  24. ncbi A comparison of dabigatran etexilate with warfarin in patients with mechanical heart valves: THE Randomized, phase II study to evaluate the safety and pharmacokinetics of oral dabigatran etexilate in patients after heart valve replacement (RE-ALIGN)
    Frans Van de Werf
    University Hospitals Leuven, Department of Cardiovascular Medicine, Leuven, Belgium
    Am Heart J 163:931-937.e1. 2012
    ..Vitamin K antagonists are the only oral anticoagulants approved for long-term treatment of patients with a cardiac valve replacement...
  25. ncbi Comparison of outcomes among patients randomized to warfarin therapy according to anticoagulant control: results from SPORTIF III and V
    Harvey D White
    Green Lane Cardiovascular Service, Auckland City Hospital, Auckland 1030, New Zealand
    Arch Intern Med 167:239-45. 2007
    Warfarin sodium reduces stroke risk in patients with atrial fibrillation, but international normalized ratio (INR) monitoring is required...
  26. ncbi The effect of warfarin and intensity of anticoagulation on outcome of intracerebral hemorrhage
    Jonathan Rosand
    Neurology Clinical Trials Unit, Department of Neurology, Massachusetts General Hospital, 15 Parkman Street, Boston, MA 02114, USA
    Arch Intern Med 164:880-4. 2004
    ..We studied the determinants of ICH outcome to quantify the independent effect of warfarin...
  27. ncbi Clopidogrel plus aspirin versus oral anticoagulation for atrial fibrillation in the Atrial fibrillation Clopidogrel Trial with Irbesartan for prevention of Vascular Events (ACTIVE W): a randomised controlled trial
    S Connolly
    Health Research Institute, Hamilton, ON, Canada
    Lancet 367:1903-12. 2006
    ..However, long-term monitoring is necessary and many patients cannot achieve optimum anticoagulation. We assessed whether clopidogrel plus aspirin was non-inferior to oral anticoagulation therapy for prevention of vascular events...
  28. ncbi Bleeding complications with warfarin use: a prevalent adverse effect resulting in regulatory action
    Diane K Wysowski
    Division of Drug Risk Evaluation, Food and Drug Administration, White Oak, Bldg 22, Room 3424, 10903 New Hampshire Ave, Silver Spring, MD 20993, USA
    Arch Intern Med 167:1414-9. 2007
    ..Warfarin sodium is widely used and causes bleeding; a review might suggest the need for regulatory action by the US Food and Drug Administration (FDA)...
  29. pmc Evaluation of the pattern of treatment, level of anticoagulation control, and outcome of treatment with warfarin in patients with non-valvar atrial fibrillation: a record linkage study in a large British population
    M Jones
    School of Mathematics, Cardiff University, Cardiff, UK
    Heart 91:472-7. 2005
    ..0-3.0 and to explore the relation between achieved INR control and clinical outcomes...
  30. ncbi Individual time within target range in patients treated with vitamin K antagonists: main determinant of quality of anticoagulation and predictor of clinical outcome. A retrospective study of 2300 consecutive patients with venous thromboembolism
    Nic J G M Veeger
    Division of Haemostasis, Thrombosis and Rheology, University Hospital Groningen, 9700 RB Groningen, The Netherlands
    Br J Haematol 128:513-9. 2005
    ..safety of vitamin K antagonists (VKA) are related to the actual level of anticoagulation (given as the international normalized ratio, INR). It is often difficult to maintain an optimal INR over time...
  31. ncbi Warfarin anticoagulation and outcomes in patients with atrial fibrillation: a systematic review and metaanalysis
    Matthew W Reynolds
    MetaWorks Inc, 10 President s Landing, Third Floor, Medford, MA 02155, USA
    Chest 126:1938-45. 2004
    To examine the relationship between international normalized ratio (INR) and outcomes (major bleeding events and strokes) in patients with atrial fibrillation (AF) receiving anticoagulation with warfarin.
  32. ncbi A multinational investigation of time and traveling costs in attending anticoagulation clinics
    Sue Jowett
    Health Economics Facility, Health Services Management Center, University of Birmingham, Birmingham, UK
    Value Health 11:207-12. 2008
    ..The therapy requires regular monitoring and, frequently, dose adjustment. This study aimed to determine the time and traveling costs that patients incur to themselves and society in attending anticoagulation clinics...
  33. ncbi Genotypes of the cytochrome p450 isoform, CYP2C9, and the vitamin K epoxide reductase complex subunit 1 conjointly determine stable warfarin dose: a prospective study
    John F Carlquist
    Department of Medicine, Division of Cardiology, University of Utah School of Medicine, Cardiovascular Department, LDS Hospital, Salt Lake City, Utah, USA
    J Thromb Thrombolysis 22:191-7. 2006
    ..vitamin K epoxide reductase complex subunit 1-VKORC1). We hypothesized that variants in these two genes explain a substantial proportion of variability in stable warfarin dose and could be used as a basis for improved dosing algorithms...
  34. ncbi Effects of CYP2C9 and VKORC1 on INR variations and dose requirements during initial phase of anticoagulant therapy
    Marta Spreafico
    A Bianchi Bonomi Hemophilia and Thrombosis Center, University of Milan and Department of Medicine and Medical Specialties, IRCCS Maggiore Hospital, Mangiagalli and Regina Elena Foundation, Via Pace 9, 20122 Milan, Italy
    Pharmacogenomics 9:1237-50. 2008
    ..However, they have a narrow therapeutic range and show inter- and intra-individual variability in dose requirement, largely conditioned by both environmental and genetic factors...
  35. ncbi Use of pharmacogenetics and clinical factors to predict the maintenance dose of warfarin
    Brian F Gage
    Department of Medicine, Washington University School of Medicine Campus Box 8005, 660 S Euclid Ave St Louis, Missouri 63110, USA
    Thromb Haemost 91:87-94. 2004
    ..001). In conclusion, the maintenance warfarin dose can be estimated from demographic, clinical, and pharmacogenetic factors that can be obtained at the time of warfarin initiation...
  36. pmc Integration of genetic, clinical, and INR data to refine warfarin dosing
    P Lenzini
    Department of Internal Medicine, Washington University, St Louis, Missouri, USA
    Clin Pharmacol Ther 87:572-8. 2010
    ..reductase complex 1 (VKORC1)) explain one-third of the variability in therapeutic dose before the international normalized ratio (INR) is measured...
  37. ncbi Patient characteristics associated with oral anticoagulation control: results of the Veterans AffaiRs Study to Improve Anticoagulation (VARIA)
    A J Rose
    Center for Health Quality, Outcomes, and Economic Research, Bedford VA Medical Center, MA 01730, USA
    J Thromb Haemost 8:2182-91. 2010
    ..In patients receiving oral anticoagulation, improved control can reduce adverse outcomes such as stroke and major hemorrhage. However, little is known about patient-level predictors of anticoagulation control...
  38. ncbi Genotype-guided dosing of coumarin derivatives: the European pharmacogenetics of anticoagulant therapy (EU-PACT) trial design
    Rianne M F van Schie
    Utrecht University, Faculty of Science, Utrecht, The Netherlands
    Pharmacogenomics 10:1687-95. 2009
    ..The primary outcome measure is the percentage time in the therapeutic range for international normalized ratio. This report describes the design and protocol for the trial.
  39. ncbi Addition of serum sodium into the MELD score predicts waiting list mortality better than MELD alone
    Andres E Ruf
    Liver Unit, Fundacion Favaloro, Buenos Aires, Argentina
    Liver Transpl 11:336-43. 2005
    ..In conclusion, addition of serum sodium to MELD identified a subgroup of patients with poor outcome in a more efficient way than MELD alone and significantly increased the efficacy of the score to predict waitlist mortality...
  40. ncbi The international normalized ratio calibrated for cirrhosis (INR(liver)) normalizes prothrombin time results for model for end-stage liver disease calculation
    Armando Tripodi
    Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Department of Internal Medicine and Medical Specialties, Milan, Italy
    Hepatology 46:520-7. 2007
    ..transplantation and includes results for creatinine, bilirubin, and prothrombin time (PT) expressed as international normalized ratio (INR)...
  41. pmc Frequency of adverse events in patients with poor anticoagulation: a meta-analysis
    Natalie Oake
    Department of Medicine, University of Ottawa, Ottawa, Ont
    CMAJ 176:1589-94. 2007
    ..To gauge the potential effect of improved anticoagulation control, we undertook to determine the proportion of anticoagulant-associated events that occur when INRs are outside the therapeutic range...
  42. ncbi Influence of coagulation factor, vitamin K epoxide reductase complex subunit 1, and cytochrome P450 2C9 gene polymorphisms on warfarin dose requirements
    Christina L Aquilante
    Department of Pharmacy Practice, University of Florida College of Pharmacy, Gainesville, FL 32610, USA
    Clin Pharmacol Ther 79:291-302. 2006
    ....
  43. ncbi Quality of anticoagulation management among patients with atrial fibrillation: results of a review of medical records from 2 communities
    G P Samsa
    Center for Clinical Health Policy Research, Department of Medicine, Duke University Medical Center, Durham, NC 27705, USA
    Arch Intern Med 160:967-73. 2000
    ..Although many studies have addressed the proportion of eligible patients with atrial fibrillation (AF) receiving warfarin sodium, few have addressed the quality of their anticoagulation management...
  44. pmc Impact of the CYP4F2 p.V433M polymorphism on coumarin dose requirement: systematic review and meta-analysis
    E Danese
    Division of Internal Medicine C, Department of Medicine, University Hospital of Verona, Verona, Italy
    Clin Pharmacol Ther 92:746-56. 2012
    ..6-11.1%; P < 0.0001) higher mean daily coumarin dose than CC homozygotes to reach a stable international normalized ratio (INR). There was no evidence of publication bias. Heterogeneity among studies was present (I(2) = 43%)...
  45. ncbi A pharmacometric model describing the relationship between warfarin dose and INR response with respect to variations in CYP2C9, VKORC1, and age
    A K Hamberg
    Department of Medical Sciences, Clinical Pharmacology, Uppsala University Hospital, Uppsala, Sweden
    Clin Pharmacol Ther 87:727-34. 2010
    ..the study was to update a previous NONMEM model to describe the relationship between warfarin dose and international normalized ratio (INR) response, to decrease the dependence of the model on pharmacokinetic (PK) data, and to improve ..
  46. pmc Training for patients in a randomised controlled trial of self management of warfarin treatment
    Ellen Murray
    Department of Primary Care and General Practice, Medical School, University of Birmingham, Birmingham B15 2TT
    BMJ 328:437-8. 2004
  47. ncbi A structured teaching and self-management program for patients receiving oral anticoagulation: a randomized controlled trial. Working Group for the Study of Patient Self-Management of Oral Anticoagulation
    P T Sawicki
    Heinrich Heine University, Department of Metabolic Diseases and Nutrition Co Coordinating Center, Dusseldorf, Germany
    JAMA 281:145-50. 1999
    ..Control of oral anticoagulation therapy has been reported to often be inadequate. Previous retrospective investigations suggest that patients' self-adjustment of oral anticoagulants may lead to improved control...
  48. ncbi Quality assessment of anticoagulation dose management: comparative evaluation of measures of time-in-therapeutic range
    L Schmitt
    Departments of Medicine and Pharmacy, Boston University Medical Center, 88 East Newton Street, Boston, MA 02118, USA
    J Thromb Thrombolysis 15:213-6. 2003
    ..Time-in-therapeutic range (TTR) is one measure of quality of anticoagulation dose management, but various methodologies exist for measuring TTR...
  49. ncbi Preanalytical variables and off-site blood collection: influences on the results of the prothrombin time/international normalized ratio test and implications for monitoring of oral anticoagulant therapy
    Johanna H H van Geest-Daalderop
    Thrombosis Service, Department of Laboratory of Clinical Chemistry and Haematology, Jeroen Bosch Hospital, s Hertogenbosch, The Netherlands
    Clin Chem 51:561-8. 2005
    ..therapy management with coumarin derivatives requires reliable results for the prothrombin time/International Normalized Ratio (PT/INR)...
  50. pmc Influence of CYP2C9 and VKORC1 on warfarin dose, anticoagulation attainment and maintenance among European-Americans and African-Americans
    Nita A Limdi
    University of Alabama at Birmingham, Department of Neurology, 1719 6th Avenue South, CIRC 312, Birmingham, AL 35294 0021, USA
    Pharmacogenomics 9:511-26. 2008
    The influence of CYP2C9 and VKORC1 on warfarin dose, time to target International Normalized Ratio (INR), time to stabilization, and risk of over-anticoagulation (INR: > 4) was assessed after adjustment for clinical factors, ..
  51. ncbi The interval between prothrombin time tests and the quality of oral anticoagulants treatment in patients with chronic atrial fibrillation
    Varda Shalev
    Anticoagulant Clinic and Laboratory of Maccabi Health Services, Tel Aviv, Israel
    Thromb Res 120:201-6. 2007
    ..The incidence of stroke in patients with atrial fibrillation (AF) can be significantly reduced with warfarin therapy especially if optimally controlled...
  52. pmc Impact of global geographic region on time in therapeutic range on warfarin anticoagulant therapy: data from the ROCKET AF clinical trial
    Daniel E Singer
    Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
    J Am Heart Assoc 2:e000067. 2013
    ..Time in therapeutic range (TTR) is a widely cited measure of the quality of VKA therapy. We sought to identify factors associated with TTR in a large, international clinical trial...
  53. ncbi Monitoring anticoagulation in atrial fibrillation
    Chaitanya Sarawate
    HealthCore, 800 Delaware Ave 5th Floor, Wilmington, DE 19801, USA
    J Thromb Thrombolysis 21:191-8. 2006
    ....
  54. ncbi Effect of home testing of international normalized ratio on clinical events
    David B Matchar
    Health Services Research Field Program, Veterans Affairs Medical Center, Durham, NC, USA
    N Engl J Med 363:1608-20. 2010
    ..with atrial fibrillation or mechanical heart valves, but effective management is complex, and the international normalized ratio (INR) is often outside the target range...
  55. ncbi Results of the first randomized French study evaluating self-testing of the International Normalized Ratio
    Kasra Azarnoush
    Heart Surgery Department, Hôpital Gabriel Montpied CHU Clermont Ferrand, France
    J Heart Valve Dis 20:518-25. 2011
    ..the conventional management of patients receiving vitamin K antagonists (VKAs) was compared with an International Normalized Ratio (INR) self-testing program...
  56. ncbi Potentially preventable strokes in high-risk patients with atrial fibrillation who are not adequately anticoagulated
    David J Gladstone
    FRCPC, Director, Regional Stroke Prevention Clinic, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Room A442, Toronto, Ontario, Canada
    Stroke 40:235-40. 2009
    ..This study examined the magnitude of this problem in a large contemporary, prospective stroke registry...
  57. ncbi 10 years of oral anticoagulant pharmacogenomics: what difference will it make? A critical appraisal
    Daniel Kurnik
    Division of Clinical Pharmacology and Toxicology, Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel
    Pharmacogenomics 10:1955-65. 2009
    ..much of the information on warfarin sensitivity conveyed by genetic variants is captured by early international normalized ratio values traditionally used to guide dose titration...
  58. ncbi Influence of dietary vitamin K intake on subtherapeutic oral anticoagulant therapy
    Eva K Rombouts
    Department of Thrombosis and Haemostasis, Leiden University Medical Centre, Leiden, The Netherlands
    Br J Haematol 149:598-605. 2010
    ..Dutch anticoagulation clinic, to determine the association between vitamin K intake and subtherapeutic International Normalized Ratio (INR) values and the interaction between usual and recent vitamin K intake...
  59. ncbi Relationship between test frequency and outcomes of anticoagulation: a literature review and commentary with implications for the design of randomized trials of patient self-management
    G P Samsa
    Center for Clinical Health Policy Research, Department of Medicine, Department of Community and Family Medicine, Duke University Medical Center, Durham, NC 27705, USA
    J Thromb Thrombolysis 9:283-92. 2000
    ....
  60. ncbi Frequency of CYP2C9 polymorphisms affecting warfarin metabolism in a large anticoagulant clinic cohort
    Majid Moridani
    School of Pharmacy, Texas Tech University Health Sciences Center, Amarillo, TX 79106, USA
    Clin Biochem 39:606-12. 2006
    ....
  61. ncbi Reliability of point-of-care prothrombin time testing in a community clinic: a randomized crossover comparison with hospital laboratory testing
    Caroline R Shiach
    Department of Clinical Haematology, Manchester Royal Infirmary, UK
    Br J Haematol 119:370-5. 2002
    The success in achieving therapeutic international normalized ratio (INR) targets in the control of warfarin using a whole-blood point-of-care testing (POCT) monitor (CoaguChek) in a community clinic was compared with hospital laboratory ..
  62. ncbi Relation between quality of anticoagulant treatment and the development of the postthrombotic syndrome
    C J J van Dongen
    Department of Clinical Epidemiology and Biostatistics, Academic Medical Center, Amsterdam, Netherlands
    J Thromb Haemost 3:939-42. 2005
    ..During treatment with vitamin K antagonists (VKA) patients spend only 60% of time between an International Normalized Ratio (INR) of 2.0 and 3.0...
  63. ncbi Changes in international normalized ratio (INR) and model for endstage liver disease (MELD) based on selection of clinical laboratory
    J F Trotter
    University of Colorado Health Sciences Center, Denver, CO, USA
    Am J Transplant 7:1624-8. 2007
    ..is based on the Model for Endstage Liver Disease (MELD) score, a mathematical function which includes international normalized ratio (INR)...
  64. ncbi VKORC1 and CYP2C9 polymorphisms are associated with warfarin dose requirements in Turkish patients
    G Oner Ozgon
    University of Istanbul, Istanbul, Turkey
    Eur J Clin Pharmacol 64:889-94. 2008
    ..The objective of this study was to determine the quantitative influence of vitamin K epoxide reductase complex subunit 1 (VKORC1) and cytochrome P450 2C9 (CYP 2C9) polymorphisms on warfarin dose requirements in Turkish patients...
  65. pmc Oral anticoagulation and risk of death: a medical record linkage study
    Anders Oden
    Valler 190, S 442 92 Romelanda, Sweden
    BMJ 325:1073-5. 2002
    ..To study how mortality varies with different degrees of anticoagulation reflected by the international normalised ratio (INR)...
  66. ncbi Enhanced thrombin generation in patients with cirrhosis-induced coagulopathy
    A Gatt
    The Haemophilia Centre and Thrombosis Unit, Royal Free Hospital, London, UK
    J Thromb Haemost 8:1994-2000. 2010
    Prothrombin time (PT) and the international normalized ratio (INR) are still routinely measured in patients with liver cirrhosis to 'assess' their bleeding risk despite the lack of correlation with the two...
  67. ncbi Contribution of age, body weight, and CYP2C9 and VKORC1 genotype to the anticoagulant response to warfarin: proposal for a new dosing regimen in Chinese patients
    Liyan Miao
    Department of Clinical Pharmacology Research Lab, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
    Eur J Clin Pharmacol 63:1135-41. 2007
    ..The objective of this study was to assess the contribution of the VKORC1 and CYP2C9 genotypes and age, body size, and weight of the patients to the warfarin dose requirement in a Chinese population...
  68. ncbi Improved anticoagulant control in patients using home international normalized ratio testing and decision support provided through the Internet
    P Harper
    Palmerston North Hospital, Palmerston North, New Zealand
    Intern Med J 41:332-7. 2011
    ..To compare anticoagulant control using self-testing and decision support provided via the internet with standard laboratory testing...
  69. ncbi Suboptimal effect of a three-factor prothrombin complex concentrate (Profilnine-SD) in correcting supratherapeutic international normalized ratio due to warfarin overdose
    Lorne Holland
    Department of Pathology, The University of Texas Southwestern Medical Center, Dallas, TX 75390 9073, USA
    Transfusion 49:1171-7. 2009
    ....
  70. ncbi Periprocedural stroke and management of major bleeding complications in patients undergoing catheter ablation of atrial fibrillation: the impact of periprocedural therapeutic international normalized ratio
    Luigi Di Biase
    Executive Texas Cardiac Arrhythmia Institute, St David s Medical Center, 1015 E 32th St, Suite 516, Austin, TX 78705, USA
    Circulation 121:2550-6. 2010
    ....
  71. ncbi Atrial fibrillation ablation in patients with therapeutic international normalized ratio: comparison of strategies of anticoagulation management in the periprocedural period
    Oussama M Wazni
    Center for Atrial Fibrillation, Cleveland Clinic, 60 Stonewood Dr, Cleveland, OH 44022, USA
    Circulation 116:2531-4. 2007
    ..The best approach to management of anticoagulation before and after atrial fibrillation ablation is not known...
  72. ncbi Pharmacology and management of the vitamin K antagonists: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition)
    Jack Ansell
    Department of Medicine, Boston University Medical Center, 88 East Newton Street, Boston, MA 02118, USA
    Chest 133:160S-198S. 2008
    ..5 mg and 10 mg for the first 1 or 2 days for most individuals, with subsequent dosing based on the international normalized ratio (INR) response (Grade 1B); we suggest against pharmacogenetic-based dosing until randomized data ..
  73. ncbi Antithrombotic therapy for venous thromboembolic disease: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition)
    Clive Kearon
    Hamilton Health Sciences, Henderson Division, 711 Concession Street, Hamilton, Ontario, Canada
    Chest 133:454S-545S. 2008
    ..or fondaparinux on the first treatment day, and discontinuation of these heparin preparations when the international normalized ratio (INR) is > or = 2.0 for at least 24 h (Grade 1A)...
  74. ncbi Comparison of low-intensity warfarin therapy with conventional-intensity warfarin therapy for long-term prevention of recurrent venous thromboembolism
    Clive Kearon
    McMaster University, Hamilton, Ont
    N Engl J Med 349:631-9. 2003
    ..After three months of conventional warfarin therapy, a lower dose of anticoagulant medication may result in less bleeding and still prevent recurrent venous thromboembolism...
  75. ncbi Patients with an ApoE epsilon4 allele require lower doses of coumarin anticoagulants
    Loes E Visser
    Pharmacoepidemiology Unit, Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
    Pharmacogenet Genomics 15:69-74. 2005
    ..Therefore, we investigated whether this common genetic polymorphism influenced dose requirements and effects of coumarin anticoagulants...
  76. ncbi A comparison of two intensities of warfarin for the prevention of recurrent thrombosis in patients with the antiphospholipid antibody syndrome
    Mark A Crowther
    Department of Medicine, McMaster University, Hamilton, Ont, Canada
    N Engl J Med 349:1133-8. 2003
    ..antibody syndrome and recurrent thrombosis receive doses of warfarin adjusted to achieve an international normalized ratio (INR) of more than 3.0...
  77. ncbi Point-of-care international normalized ratio testing accelerates thrombolysis in patients with acute ischemic stroke using oral anticoagulants
    Timolaos Rizos
    Department of Neurology, University Heidelberg, 69120 Heidelberg Germany
    Stroke 40:3547-51. 2009
    ..By using point-of-care (POC) coagumeters, international normalized ratio (INR) values can be measured immediately at the bedside...
  78. pmc Polymorphisms in the VKORC1 gene are strongly associated with warfarin dosage requirements in patients receiving anticoagulation
    T Li
    University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
    J Med Genet 43:740-4. 2006
    ..However, the use of this common agent is fraught with complications and little is known regarding inter-individual variation in warfarin response...
  79. ncbi An international multicenter randomized study of computer-assisted oral anticoagulant dosage vs. medical staff dosage
    L Poller
    EAA Central Facility, Faculty of Life Sciences, University of Manchester, Manchester, UK
    J Thromb Haemost 6:935-43. 2008
    ..A multicenter clinical endpoint study has been performed to compare the safety and effectiveness of computer-assisted dosage with dosage by experienced medical staff at the same centers...
  80. pmc Is INR between 2.0 and 3.0 the optimal level for Chinese patients on warfarin therapy for moderate-intensity anticoagulation?
    J H S You
    School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
    Br J Clin Pharmacol 59:582-7. 2005
    To examine the optimal range of International Normalized Ratio (INR) for Chinese patients receiving warfarin for moderate-intensity anticoagulation.
  81. ncbi The value of education and self-monitoring in the management of warfarin therapy in older patients with unstable control of anticoagulation
    Tayyaba Irfan Khan
    School of Clinical and Laboratory Sciences, University of Newcastle, Newcastle upon Tyne, UK
    Br J Haematol 126:557-64. 2004
    ..warfarin for at least 12 months, with a standard deviation (SD) of prothrombin time, expressed as the International Normalized Ratio (INR) >0...
  82. ncbi Genetic factors (VKORC1, CYP2C9, EPHX1, and CYP4F2) are predictor variables for warfarin response in very elderly, frail inpatients
    E Pautas
    Universite Paris Descartes, Paris, France
    Clin Pharmacol Ther 87:57-64. 2010
    ..The time to first international normalized ratio (INR) > or =2 was influenced by VKORC1 and CYP2C9 genotypes (P = 0.0003 and P = 0...
  83. ncbi A modified international normalized ratio as an effective way of prothrombin time standardization in hepatology
    Laurent Bellest
    AP HP, Hopital St Antoine, Unite d hémostase, Universite Pierre et Marie Curie, Paris, France
    Hepatology 46:528-34. 2007
    b>International Normalized Ratio (INR), which standardizes prothrombin time (PT) during oral anticoagulation, has been extended to standardize PT in liver diseases and is included in prognostic models such as the Model for End stage Liver ..
  84. ncbi Common genetic variants of microsomal epoxide hydrolase affect warfarin dose requirements beyond the effect of cytochrome P450 2C9
    Ronen Loebstein
    Institute of Clinical Pharmacology and Toxicology, Chaim Sheba Medical Center, Tel Hashomer 52621, Israel
    Clin Pharmacol Ther 77:365-72. 2005
    ....
  85. ncbi Comparison of fresh frozen plasma and prothrombin complex concentrate for the reversal of oral anticoagulants in patients undergoing cardiopulmonary bypass surgery: a randomized study
    R Demeyere
    Department of Anaesthesiology, University Hospital Gasthuisberg, Leuven, Belgium
    Vox Sang 99:251-60. 2010
    ..Fresh frozen plasma (FFP) and prothrombin complex concentrates (PCC) reverse oral anticoagulants. We compared PCC and FFP intraoperative administration in patients undergoing heart surgery with cardiopulmonary bypass (CPB)...
  86. pmc Dosing algorithms to predict warfarin maintenance dose in Caucasians and African Americans
    H Schelleman
    Center for Clinical Epidemiology and Biostatistics, Department of Biostatistics and Epidemiology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
    Clin Pharmacol Ther 84:332-9. 2008
    ..The dosing algorithms explained <45% of the observed variability in Caucasians, and the algorithms performed only marginally better for African Americans when compared with giving 5 mg empirically...
  87. pmc Cost-effectiveness of self-managed versus physician-managed oral anticoagulation therapy
    Dean A Regier
    Collaboration for Outcomes Research and Evaluation, Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, University of British Columbia, Vancouver, BC
    CMAJ 174:1847-52. 2006
    ..We sought to compare the incremental cost and health benefits of self-management with those of physician management from the perspective of the Canadian health care payer over a 5-year period...
  88. ncbi Warfarin response and vitamin K epoxide reductase complex 1 in African Americans and Caucasians
    H Schelleman
    Center for Clinical Epidemiology and Biostatistics, Department of Biostatistics and Epidemiology, University of Pennsylvania School of Medicine, and Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA
    Clin Pharmacol Ther 81:742-7. 2007
    ..reaching maintenance dose, only Caucasians with the T allele had significantly increased risk of international normalized ratio >3 (odds ratio=3.10; 95% confidence interval: 1.73-5...
  89. ncbi How to interpret and pursue an abnormal prothrombin time, activated partial thromboplastin time, and bleeding time in adults
    Arif H Kamal
    Department of Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA
    Mayo Clin Proc 82:864-73. 2007
    ....
  90. ncbi Warfarin and cytochrome P450 2C9 genotype: possible ethnic variation in warfarin sensitivity
    Carmel Kealey
    University of Pennsylvania, Department of Pharmacology and Center for Pharmacogenetics, School of Medicine, Philadelphia, PA, USA
    Pharmacogenomics 8:217-25. 2007
    ....
  91. ncbi The effect of recombinant factor VIIa (NovoSeven) in healthy volunteers receiving acenocoumarol to an International Normalized Ratio above 2.0
    E Erhardtsen
    Novo Nordisk A S, Copenhagen, Denmark
    Blood Coagul Fibrinolysis 9:741-8. 1998
    ..After administration of acenocoumarol (International Normalized Ratio > 2), decreased levels of factor X and factor IX (19-46%), protein C (2-20%) and factor VII (4-17%) ..
  92. ncbi Association between CYP2C9 genetic variants and anticoagulation-related outcomes during warfarin therapy
    Mitchell K Higashi
    University of Washington, Department of Pharmacy, Box 357630, Health Sciences Bldg, Room H 375A, Seattle, WA 98195, USA
    JAMA 287:1690-8. 2002
    ..Patients with these genetic variants have been shown to require lower maintenance doses of warfarin, but a direct association between CYP2C9 genotype and anticoagulation status or bleeding risk has not been established...
  93. ncbi Acenocoumarol stabilization is delayed in CYP2C93 carriers
    Tom Schalekamp
    Department of Pharmacoepidemiology and Pharmacotherapy, Utrecht University, Utrecht, The Netherlands
    Clin Pharmacol Ther 75:394-402. 2004
    ..Our objective was to assess whether there is an association between the presence of allelic variants of the gene for cytochrome P450 (CYP) 2C9 and anticoagulation problems during the initial 3 to 6 months of acenocoumarol treatment...
  94. ncbi Comparison of three methods to assess therapeutic quality control of treatment with vitamin K antagonists
    B A Hutten
    Department of Clinical Epidemiology and Biostatistics, Academic Medical Center, University of Amsterdam, The Netherlands
    Thromb Haemost 82:1260-3. 1999
    ..Since these differences were small, linear interpolation is preferable to the hybrid method, since the calculations involved are easier...
  95. ncbi Oral anticoagulant therapy. Fundamentals, clinical practice and recommendations
    R Lemos Silva
    Hospital de Santa Maria, Lisboa, Portugal
    Rev Port Cardiol 26:769-88. 2007
    ..Finally, risk factors for deep venous thrombosis and pulmonary embolism are detailed in this review, presenting current clinical recommendations for oral anticoagulation of these patients...
  96. ncbi Effect of CYP2C9 and VKORC1 genotypes on early-phase and steady-state warfarin dosing in Korean patients with mechanical heart valve replacement
    Ho Sook Kim
    Department of Pharmacology and PharmacoGenomics Research Center, Inje University College of Medicine, Busan, Korea
    Pharmacogenet Genomics 19:103-12. 2009
    ..The effect of CYP2C9 and vitamin K epoxide reductase complex subunit 1 (VKORC1) genotypes was evaluated for the early-phase and steady-state warfarin dosing in Korean patients with mechanical heart valve replacement...
  97. ncbi Genetic and environmental risk factors for oral anticoagulant overdose
    C Verstuyft
    Department of Pharmacology, Saint Antoine Paris VI University and Assistance Publique Hôpitaux de Paris, 184 rue du Faubourg Saint Antoine, 75012, Paris, France
    Eur J Clin Pharmacol 58:739-45. 2003
    ..Cytochrome P450 2C9 (CYP2C9) allelic variant carriers have been shown to experience hyper-responsiveness to small doses of oral anticoagulants (OAs) (warfarin or acenocoumarol) and a higher bleeding rate...
  98. ncbi Interaction of daptomycin with two recombinant thromboplastin reagents leads to falsely prolonged patient prothrombin time/International Normalized Ratio results
    Peggy S Webster
    Cubist Pharmaceuticals, Inc, Lexington, Massachusetts 02421, USA
    Blood Coagul Fibrinolysis 19:32-8. 2008
    A cluster of patients experiencing elevations of International Normalized Ratio without clinical bleeding in temporal association with daptomycin therapy was identified during postmarketing safety surveillance...
  99. pmc Evaluation of survival and ischaemic and thromboembolic event rates in patients with non-valvar atrial fibrillation in the general population when treated and untreated with warfarin
    C J Currie
    School of Medicine, Cardiff University, Cardiff, UK
    Heart 92:196-200. 2006
    ..To compare survival and adverse outcome of patients with non-valvar atrial fibrillation (NVAF) treated with or without warfarin...
  100. ncbi Anticoagulation quality and the risk of recurrence of venous thromboembolism
    Daniela Poli
    Thromb Haemost 98:1148-50. 2007
  101. ncbi Comparison of emergency department point-of-care international normalised ratio (INR) testing with laboratory-based testing
    Antonio Celenza
    Emergency Department, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
    Emerg Med J 28:136-40. 2011
    ..Bedside international normalised ratio (INR) testing in emergency departments (ED) to assess for coagulopathies has not previously been examined...

Research Grants56

  1. Genetic and Environmental Determinants of Warfarin Response
    Nita A Limdi; Fiscal Year: 2012
    ..the influence of a single gene;cytochrome P450 2C9 (CYP2C9) genotype on warfarin dose, frequency of International Normalized Ratio (INR) outside target range, and risk of complications, the cohort provides a valuable racially diverse ..
  2. GENETICS-InFORMATICS TRIAL (GIFT) OF WARFARIN TO PREVENT DVT
    Brian F Gage; Fiscal Year: 2013
    ..e., a target International Normalized Ratio (INR) <2.0) for VTE prevention in orthopedic patients...
  3. Development Of Prognostic Platelet RNA Biomarkers To Tailor Antiplatelet Therapy
    Deepak Voora; Fiscal Year: 2013
    ..Our results are expected to have an important positive impact, because analogous to the International Normalized Ratio for warfarin, developing such an assay is a critical step towards a novel treatment paradigm where use ..
  4. Randomized Clinical Trial of Genotype Guided Dosing of Warfarin Therapy
    STEPHEN KIMEL; Fiscal Year: 2011
    ..dosing practices for warfarin are empiric and result in the need for frequent dose changes as the International Normalized Ratio (INR) gets too high or too low...
  5. Improving Anti-Thrombotic Use in Stroke Prevention
    Rebecca Beyth; Fiscal Year: 2006
    ..anticoagulated patients with major bleeds, and the proportion of total treatment time during which the International Normalized Ratio is below, above and within therapeutic range...
  6. Pharmacogenetics, Biomarkers, and Antithrombotic Therapy
    Brian Gage; Fiscal Year: 2006
    ..comparison of warfarin management by an anticoagulation clinic versus patient self-testing of their International Normalized Ratio (INR)...
  7. Pharmacogenetics and Antithrombotic Therapy
    Brian Gage; Fiscal Year: 2003
    ..Using high performance liquid chromatography, we will measure the levels of the 2 enantiomers of warfarin and test Hypothesis 4: Clearance of S-warfarin will be significantly decreased in the presence of 2C9 SNPs. ..
  8. Harvard Planning Grant for Institutional Clinical and Translational Science Award
    Daniel Singer; Fiscal Year: 2006
    ..We believe our planning process is specific, innovative yet disciplined, and should be robust. A full and competitive CTSA application will be produced in a timely manner. [unreadable] [unreadable] [unreadable]..
  9. EPIDEMIOLOGY OF ANTICOAGULATION IN ATRIAL FIBRILLATION
    Daniel Singer; Fiscal Year: 2005
    ..In all, continued study of our cohort will efficiently provide powerful insights into optimizing stroke prevention strategies for the many older Americans with AF. ..
  10. Pharmacogenetic Optimization of Anticoagulation Therapy
    Nita Limdi; Fiscal Year: 2007
    ..With the award of the K23 grant, structured training, guidance of mentors, environment and institutional support provided by the University, I will develop the skills necessary for a productive career in pharmacogenetics research. ..
  11. Individual Propensity to Venous Thrombosis
    John Heit; Fiscal Year: 2009
    ..However, the incidence of VTE has remained relatively constant at about 1 per 1000 since 1980. Clearly, better methods of targeting VTE prophylaxis are needed. ..
  12. PRIMARY STRUCTURE OF PROTHROMBIN
    Kenneth Mann; Fiscal Year: 2008
    ..The major aim of this project is to elucidate the structure/function relationships of this material with respect to factor V inactivation and to access its potential significance in the pathology of human thrombosis. ..
  13. Reducing Adverse Self-Medication Behaviors in Older Adults with Hypertension
    Patricia Neafsey; Fiscal Year: 2007
    ..Healthcare utilization will be compared between the 2 groups after 52 weeks and a cost-benefit analysis conducted. [unreadable] [unreadable] [unreadable]..
  14. Health Information Technology in the Nursing Home
    Jerry Gurwitz; Fiscal Year: 2006
    ..abstract_text> ..
  15. Patient Oriented Research in Anticoagulation
    Stephen Kimmel; Fiscal Year: 2006
    ..The ultimate goal is to improve the use of a highly efficacious, but underused, drug, and reduce morbidity and mortality in the large proportion of the population at risk for TE. ..
  16. Proactive Risk Reduction in Medication Prescribing in the Ambulatory Setting
    Terry Field; Fiscal Year: 2007
    ..3. Develop action plans for implementing identified interventions. [unreadable] [unreadable] [unreadable]..
  17. Association of Thrombophilia and Inflammation with Post-Thrombotic Syndrome
    Mary Cushman; Fiscal Year: 2008
    ..Resultant disability is estimated at 2 million lost workdays/year and medical costs as $300 million yearly. Findings here can form the basis for development of new therapies to treat, and moreover prevent,PTS. ..
  18. New MRI techniques for cerebrovascular diseases
    Gregory Albers; Fiscal Year: 2008
    ..This K24 research program will expand Dr. Albers' skills as a clinical investigator and allow him to become a more effective mentor. [unreadable] [unreadable]..
  19. Liver Regeneration in the Transplant Setting
    KIM MARIE OLTHOFF; Fiscal Year: 2010
    ..Understanding the mechanistic biology of graft recovery and pathways of liver regeneration will provide important data for designing treatment modalities that will prevent injury and enhance recovery and regeneration. ..
  20. Comparative Safety and Effectiveness of Stimulants in Medicaid Youth with ADHD
    Almut G Winterstein; Fiscal Year: 2010
    ....
  21. Diffusion weighted imaging Evaluation For Understanding Stroke Evolution2:DEFUSE
    Gregory W Albers; Fiscal Year: 2010
    ..These findings will eventually lead to effective therapies for a large population of stroke patients who are currently ineligible for treatment and substantially reduce stroke-related disability. ..
  22. Endothelial Dysfunction, Oxidative Stress and Risk of Peripheral Arterial Disease
    Kenneth Jay Mukamal; Fiscal Year: 2010
    ..Finally, we will examine how a derived dietary antioxidant score, based upon measured oxidative potential of specific foods using the ferric-reducing/antioxidant power method, is related to PAD. ..
  23. Diabetes and Drug-Associated Hyperkalemia: Effect of Laboratory Monitoring
    Marsha Raebel; Fiscal Year: 2008
    ..The findings will also assist in developing a framework for future studies to evaluate the effects and costs of medication-laboratory monitoring among patients with diabetes. [unreadable] [unreadable] [unreadable] [unreadable]..
  24. Enhancing the Safety of Warfarin in the Nursing Home
    Jerry Gurwitz; Fiscal Year: 2008
    ..abstract_text> ..
  25. Prescription Drug Coverage and Health Outcomes in Elders
    Jennifer Tjia; Fiscal Year: 2008
    ..abstract_text> ..
  26. HMO Research Network Conference
    Jerry Gurwitz; Fiscal Year: 2006
    ..unreadable] [unreadable] [unreadable] [unreadable]..
  27. Stroke:Role of aPL, hemostatic markers, and telestroke
    Steven Levine; Fiscal Year: 2006
    ....
  28. PRAISE Study
    Marc Chimowitz; Fiscal Year: 2005
    ..medical therapy alone for this disease. ..
  29. Identifying Low-Risk Patients with Pulmonary Embolism
    Drahomir Aujesky; Fiscal Year: 2005
    ..abstract_text> ..
  30. PE BIOSYSTEMS VOYAGER DE MALDI-TOF
    Kenneth Mann; Fiscal Year: 2001
    ..The fulfillment of the specific aims described in detail in the twelve research proposals would be facilitated by the addiction of a Voyager-DE MALDI-TOF ..
  31. THE INTERPLAY BETWEEN HEPATIC GROWTH AND METABOLISM
    Kim Olthoff; Fiscal Year: 2004
    ..The applicant will assess basic parameters of glucose metabolism in IGFBP-1 null mice and determine the basis for any abnormalities. ..
  32. Molecular Mechanisms in Lymphatic Function & Disease
    Stanley Rockson; Fiscal Year: 2004
    ..The physiology and human genetics of the lymphatic system will be explored and there will be a focus upon mechanisms of cancer metastasis and its relationship to lymphatic function and lymphangiogenesis. ..
  33. NOVEL THERAPIES FOR ACETAMINOPHEN TOXICITY
    Laura James; Fiscal Year: 2004
    ..abstract_text> ..
  34. REDUCING ADVERSE DRUG EVENTS IN THE NURSING HOME
    Jerry Gurwitz; Fiscal Year: 2002
    ..abstract_text> ..
  35. THROMBOTIC, INFLAMMATORY & GENE MARKERS OF CVD IN WOMEN
    Paul Ridker; Fiscal Year: 2002
    ....
  36. ANTIARRHYTHMIC EFFECTS OF N-3 FATTY ACIDS
    John McAnulty; Fiscal Year: 2002
    ....
  37. Evaluation of a Biomarker for Acetaminophen Toxicity
    Laura James; Fiscal Year: 2005
    ..The data generated from this study will lead to enhanced recognition of APAP hepatotoxicity, thus allowing for better identification of "at risk" populations and the creation of prevention strategies. ..
  38. Immune Thrombocytopenia and Low-Level Mercury Exposure
    Jodi Segal; Fiscal Year: 2006
    ..Segal with the necessary support for successful completion [unreadable] [unreadable] [unreadable]..
  39. HRQL Impact of Chronic Conditions and Comorbidity Burden
    Patrick Sullivan; Fiscal Year: 2006
    ..S. [unreadable] [unreadable]..
  40. The Lymphatic Continuum Conference
    Stanley Rockson; Fiscal Year: 2002
    ..On the second day of the symposium, attendance will be limited to a working nucleus of 50-60 invited participants in order to encourage open discussion and formulation of theoretical research agendas. ..
  41. Heavy Drinking & Coronary Disease: Acute/Chronic Effects
    Kenneth Mukamal; Fiscal Year: 2006
    ..These results may prove to have important biological, clinical, and public health implications for the care of CHD. ..
  42. Genetic Markers of Thrombosis in Embolic Stroke
    Karen Furie; Fiscal Year: 2006
    ....
  43. Costs of Occupational Injury and Illness
    J Leigh; Fiscal Year: 2009
    ..But reported national injury rates have been fallen since 1992. Moreover, Workers'Compensation costs fell from 1993 to 1998 but have risen since 1999. Current and comprehensive estimates are needed. ..
  44. WARFARIN ANTIPLATELET RECURRENT STROKE STUDY
    J Mohr; Fiscal Year: 2001
    ..An emergency notification system helps maintain patient safety. Through 24-Oct-1996 1603 patients have been recruited from 49 participating centers toward the 1,920 patient sample size. ..
  45. NATURAL HISTORY AND TREATMENT OUTCOME IN BRAIN AVM
    JP MOHR; Fiscal Year: 2005
    ..The results are improving the prediction for short- and long-term outcome for embolization and surgery. ..
  46. SECONDARY PREVENTION TRIAL OF VENOUS THROMBOSIS
    Paul Ridker; Fiscal Year: 2002
    ....
  47. Screening Technology and Outcomes Project in Stroke
    Karen Furie; Fiscal Year: 2005
    ..abstract_text> ..
  48. Research:Genetics of complex traits(RMI)
    Stephen Kimmel; Fiscal Year: 2006
    ..unreadable] [unreadable]..
  49. Symphony Multiplex Peptide Synthesizer w/ VISION Workstn
    Kenneth Mann; Fiscal Year: 2004
    ..There is currently no preparative HPLC system on the campus of the University of Vermont and this system is badly needed for many investigators. ..
  50. PROSPECTIVE INVESTIGATION OF PULMONARY EMBOLISM DX-II
    Paul Stein; Fiscal Year: 2003
    ..4) The team of investigators is strong, and has collaborated previously in successful research in PE. ..
  51. Prospective Investigation for Pulmonary Embolism Dx III
    Paul Stein; Fiscal Year: 2008
    ..abstract_text> ..
  52. Care Choices and Costs for Low Back Pain
    Sylvia Kuo; Fiscal Year: 2006
    ..Such strategies may help reduce the health care expenditures associated with LBP. The findings from this proposed research will lead to a larger study which would examine outcomes and costs. [unreadable] [unreadable] [unreadable]..