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Volume 350:616-617 February 5, 2004 Number 6
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Ximelagatran versus Warfarin after Total Knee Replacement

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 by Francis, C. W.
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To the Editor: In their study of the prevention of venous thromboembolism after total knee replacement (Oct. 30 issue),1 Francis and colleagues acknowledge that warfarin has a slower onset of action than ximelagatran. They emphasize the fact that about two thirds of the patients who were randomly assigned to warfarin had a therapeutic international normalized ratio (INR) on day 3. It is well known that because of the short half-life of factor VII, the INR during the initial days of warfarin therapy mainly reflects the inhibition of this factor, thus providing a false sense of adequate anticoagulation.

In this study, . . . [Full Text of this Article]




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