Emergency reversal of vitamin-K antagonists related over-anticoagulation: case report and brief overview on the role of Prothrombin Complex Concentrate

Published: December 30, 2013
Abstract Views: 1210
PDF: 849
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.


Oral anticoagulation is a widely used treatment and atrial fibrillation (AF) is the most frequent indication. We review the therapeutic options on an important clinical challenge: rapid reversal anticoagulation in the setting of an urgent invasive procedure. We report a case of a 71-year-old man treated with warfarin who was over-anticoagulated when presented to the emergency department for syncope due to severe bradiarrhythmia and needed temporary pacing. Intravenous infusion of vitamin-k was not adequate for rapid reversal over anticoagulation whereas the administration of a Prothrombin Complex Concentrate (PCC) was able to quickly reverse anticoagulant activity and allowed the performance of an urgent invasive procedure without hemorrhagic complication. The aim of this paper is to draw attention to possible therapeutic strategies to reduce the risk of bleeding related to over-anticoagulation with vitamin-K antagonists (VKAs) in case of urgent invasive procedure, emphasizing the role of PCC in keeping with national and international guidelines.



PlumX Metrics


Download data is not yet available.


How to Cite

Di Fusco, Stefania Angela, Nadia Aspromonte, Stefano Aquilani, Luca Mele, and Furio Colivicchi. 2013. “Emergency Reversal of Vitamin-K Antagonists Related over-Anticoagulation: Case Report and Brief Overview on the Role of Prothrombin Complex Concentrate”. Monaldi Archives for Chest Disease 80 (4). https://doi.org/10.4081/monaldi.2013.21.