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Editorials |

Anticoagulation Control With Vitamin K Antagonists: How Well Are We Doing?

Deirdre A. Lane; Christopher J. Boos; Gregory Y. H. Lip
Author and Funding Information

Affiliations: Birmingham, UK
 ,  Dr. Lane is Lecturer in Medicine, Dr. Boos is Research Fellow. Dr. Lip is Professor of Cardiovascular Medicine, University Department of Medicine, City Hospital.

Correspondence to: Gregory Y. H. Lip, Haemostasis, Thrombosis, and Vascular Biology Unit, University Department of Medicine, City Hospital, Birmingham B18 7QH, UK; e-mail: g.y.h.lip@bham.ac.uk



Chest. 2006;129(5):1122-1124. doi:10.1378/chest.129.5.1122
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Over half a century since their initial inception, vitamin K antagonists (VKAs), in particular warfarin, still represent the cornerstone of oral anticoagulation (OAC) therapy worldwide. Despite their proven antithrombotic efficacy across a broad spectrum of patient groups, VKAs are beset by numerous inherent problems. The complex pharmacokinetic profile of VKAs means that they have a narrow therapeutic range requiring regular monitoring, a slow onset/offset of action, and are subject to multiple interactions with food, alcohol, and medications.1 Further, they also exhibit potential ethnic, genetic, and age-related variations in their dose response.

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