Four-factor prothrombin complex concentrate versus plasma for urgent vitamin K antagonist reversal: new evidence

Vitamin K antagonist (VKA) therapy is a mainstay of treatment for patients at risk of thromboembolic events. Despite widespread use, a major limitation of VKA therapy is the substantial risk of serious bleeding complications, which often require rapid reversal of anticoagulation. A recent randomized multicenter comparison between a 4-factor prothrombin complex concentrate (4F-PCC) and plasma in patients with acute major bleeding has provided important new evidence of the benefit of 4F-PCC over plasma for urgent VKA reversal.