The Effect of Preoperative Vitamin K on the INR in Bridging Therapy

Ashrei Bayewitz, Barbara Scorziello, Clarice Maala, Emily Giannattasio, Henny Heisler Billett

Research output: Contribution to journalArticlepeer-review


We investigated a bridging protocol using oral Vitamin K three days before scheduled surgery. 60 patients in two bridging protocols, 30 cases per protocol. The first cohort (Control group) had its warfarin held on Day-5 (five days before surgery). The intervention cohort (Vitamin K group) routinely received 2.5 mg of oral Vitamin K on Day-3 but was otherwise identically bridged. Primary outcome was INR on Day-1. Secondary outcomes included patients with INRs ≥1.5 on Day-1, bleeding episodes and elevated INR post surgery. Day-1 INR for the Vitamin K group was 1.16, vs. 1.28 for the Control group (p = 0.037). Postoperative INR was similar. Only the Control group had patients with INRs ≥1.5 on Day-1, or patients with significant bleeding. Adding Vitamin K on Day-3 leads to a safe preoperative INR and may limit other complications.

Original languageEnglish (US)
Pages (from-to)264-267
Number of pages4
JournalInternational journal of hematology
Issue number3
StatePublished - Mar 6 2015


  • Anticoagulation
  • Bridging therapy
  • Vitamin K

ASJC Scopus subject areas

  • Hematology


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