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Updated: Jun 28, 2026

The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
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Published on: February 28, 2012

Los umbrales de anticoagulación oral son los siguientes:

K E Brummel1, S G Paradis, R F Branda

  • 1Department of Biochemistry, Given Building, Health Science Complex University of Vermont, College of Medicine, Burlington, USA.

Circulation
|November 7, 2001
PubMed
Resumen
Este resumen es generado por máquina.

La terapia con warfarina muestra una variabilidad significativa en los tiempos de coagulación de la sangre y los perfiles de trombina-antitrombina III (TAT), incluso con relaciones normalizadas internacionales (INR) similares. Esto sugiere que el control de la anticoagulación puede ser menos seguro de lo previsto, con respuestas individuales que afectan a los riesgos de sangrado y coagulación.

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Área de la Ciencia:

  • Hematología Hematología.
  • Farmacología Farmacología.
  • La medicina clínica es la medicina clínica.

Sus antecedentes:

  • El monitoreo de la anticoagulación oral es crucial para prevenir el sangrado y la trombosis.
  • La terapia con warfarina requiere un manejo cuidadoso para mantener la eficacia terapéutica.
  • Las respuestas individuales de los pacientes a los anticoagulantes pueden variar significativamente.

Objetivo del estudio:

  • Para investigar la coagulación de la sangre entera en pacientes en tratamiento con warfarina con proporciones normalizadas internacionales (INR) similares.
  • Para evaluar la variabilidad en los perfiles de coagulación y la generación de trombina-antitrombina III (TAT).
  • Para explorar la relación entre la INR, los parámetros de coagulación y los niveles de factor VIII.

Principales métodos:

  • Se estudió la coagulación de la sangre entera inducida por el factor de tejido en 8 sujetos masculinos en warfarina (grupo W) y en un individuo varias veces (sujeto A).
  • Los tiempos de coagulación medidos, las tasas y niveles de formación de trombina-antitrombina III (TAT), la activación plaquetaria y la generación de fibrinopéptido A.
  • Se evaluaron los niveles de factor VIII y se correlacionaron con los años de tratamiento con warfarina.

Principales resultados:

  • Los sujetos con INRs similares exhibieron grandes variaciones en los tiempos de coagulación (6.2-23 min) y perfiles de TAT.
  • Los controles normales tenían tiempos de coagulación más cortos (5.7±0.3 min) y niveles más altos de TAT (742±91 nmol/L).
  • Los niveles de factor VIII aumentaron significativamente en el grupo W (204±34,4%) en comparación con los controles (149,4±37,4%), correlacionándose con la duración del tratamiento con warfarina (r=0,78, P=0,01).

Conclusiones:

  • El control de la anticoagulación a un rango terapéutico INR establecido puede ser menos seguro de lo asumido.
  • Existe una variabilidad individual significativa en la respuesta de la coagulación del factor tisular entre los pacientes con INRs similares.
  • Esta variabilidad sugiere diferentes riesgos de hemorragia y trombosis, potencialmente relacionados con anomalías vasculares subyacentes y mecanismos compensatorios como el aumento del Factor VIII.