{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T05:50:37Z","timestamp":1781070637545,"version":"3.54.1"},"reference-count":13,"publisher":"Georg Thieme Verlag KG","issue":"08","license":[{"start":{"date-parts":[[2024,4,16]],"date-time":"2024-04-16T00:00:00Z","timestamp":1713225600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Thromb Haemost"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>In the era of direct oral anticoagulants, vitamin K antagonists retain a clinically relevant role in thrombotic disorders. In Italy, approximately 20% of the patients on anticoagulant therapies receives a VKA, in most cases warfarin. The optimal management of this drug is challenging and cannot disregard its intricate and unpredictable pharmacokinetic properties and patient's thrombotic and bleeding risk. Several clinical issues encountered during warfarin treatment are still unanswered and are tentatively addressed by physicians. In this regard, the Italian Federation of Centers for the diagnosis of thrombotic disorders and the Surveillance of the Antithrombotic therapies (FCSA) provides some experience-based good clinical practice's suggestions on the following topics: (1) how to start the anticoagulant treatment with warfarin and warfarin induction regimen; (2) how to manage a subtherapeutic INR value; (3) how to manage a supratherapeutic INR value in asymptomatic patients; and (4) how to manage the association of warfarin with interfering drugs.<\/jats:p>","DOI":"10.1055\/s-0044-1782688","type":"journal-article","created":{"date-parts":[[2024,4,16]],"date-time":"2024-04-16T23:28:02Z","timestamp":1713310082000},"page":"803-809","source":"Crossref","is-referenced-by-count":6,"title":["Practical Suggestions for an Optimal Management of Vitamin K Antagonists: Italian Federation of Centers for the Diagnosis of Thrombotic Disorders and the Surveillance of the Antithrombotic Therapies (FCSA) Position Paper"],"prefix":"10.1055","volume":"124","author":[{"given":"Silvia","family":"Galliazzo","sequence":"additional","affiliation":[{"name":"Research Center on Thromboembolic Disorders and Antithrombotic Therapies, University of Insubria, Sant'Anna Hospital, ASST Lariana, Como, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Bucciarelli","sequence":"additional","affiliation":[{"name":"Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0823-3357","authenticated-orcid":false,"given":"Doris","family":"Barcellona","sequence":"additional","affiliation":[{"name":"Thrombosis and Haemostasis Unit, University of Cagliari, Cagliari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Ciampa","sequence":"additional","affiliation":[{"name":"Haemostasis Center, AORN S.G. Moscati, Avellino, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elvira","family":"Grandone","sequence":"additional","affiliation":[{"name":"Thrombosis and Haemostasis Unit, IRCCS, Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Malcangi","sequence":"additional","affiliation":[{"name":"Haemophilia and Thrombosis Center, AOU Policlinico, Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Rescigno","sequence":"additional","affiliation":[{"name":"Haemostasis and Thrombosis Center, DEA P.O. \u201cUmberto I,\u201d Nocera Inferiore, Salerno, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5705-2897","authenticated-orcid":false,"given":"Alessandro","family":"Squizzato","sequence":"additional","affiliation":[{"name":"Research Center on Thromboembolic Disorders and Antithrombotic Therapies, University of Insubria, Sant'Anna Hospital, ASST Lariana, Como, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo","family":"Toschi","sequence":"additional","affiliation":[{"name":"Department of Haematology and Blood Transfusion and Thrombosis Center, Santi Paolo e Carlo Hospital, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Testa","sequence":"additional","affiliation":[{"name":"Haemostasis and Thrombosis Center, ASST Cremona, Cremona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Poli","sequence":"additional","affiliation":[{"name":"Thrombosis Center, 'Careggi' Hospital, Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2024,4,16]]},"reference":[{"issue":"13","key":"ref2","doi-asserted-by":"crossref","first-page":"1299","DOI":"10.1001\/jama.2021.13844","article-title":"US emergency department visits attributed to medication harms, 2017\u20132019","volume":"326","author":"D S Budnitz","year":"2021","journal-title":"JAMA"},{"issue":"9025","key":"ref3","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1016\/S0140-6736(96)01109-9","article-title":"Bleeding complications of oral anticoagulant treatment: an inception-cohort, prospective collaborative study (ISCOAT)","volume":"348","author":"G Palareti","year":"1996","journal-title":"Lancet"},{"issue":"01","key":"ref4","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1002\/jcph.576","article-title":"A systematic review on comparing 2 common models for management of warfarin therapy; pharmacist-led service versus usual medical care","volume":"56","author":"T Entezari-Maleki","year":"2016","journal-title":"J Clin Pharmacol"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"e152S","DOI":"10.1378\/chest.11-2295","article-title":"Evidence-based management of anticoagulant therapy: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines","volume":"141","author":"A Holbrook","year":"2012","journal-title":"Chest"},{"issue":"01","key":"ref6","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1111\/j.1365-2141.2005.05417.x","article-title":"Risks factors for highly unstable response to oral anticoagulation: a case-control study","volume":"129","author":"G Palareti","year":"2005","journal-title":"Br J Haematol"},{"key":"ref7","first-page":"e44S","volume-title":"Oral anticoagulant therapy: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines","author":"W Ageno","year":"2012"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"e737S","DOI":"10.1378\/chest.11-2308","article-title":"Antithrombotic therapy in neonates and children: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines","volume":"141","author":"P Monagle","year":"2012","journal-title":"Chest"},{"issue":"06","key":"ref9","doi-asserted-by":"crossref","first-page":"2049","DOI":"10.1378\/chest.127.6.2049","article-title":"Warfarin maintenance dosing patterns in clinical practice: implications for safer anticoagulation in the elderly population","volume":"127","author":"D Garcia","year":"2005","journal-title":"Chest"},{"issue":"02","key":"ref10","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1016\/j.thromres.2008.01.020","article-title":"The relationship between maintenance dosages of three vitamin K antagonists: acenocoumarol, warfarin and phenprocoumon","volume":"123","author":"Y van Leeuwen","year":"2008","journal-title":"Thromb Res"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"e24S","DOI":"10.1378\/chest.11-2291","article-title":"Parenteral anticoagulants: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines","volume":"141","author":"D Garcia","year":"2012","journal-title":"Chest"},{"issue":"11","key":"ref12","doi-asserted-by":"crossref","first-page":"1966","DOI":"10.1111\/jth.14598","article-title":"Scientific and Standardization Committee Communication: guidance document on the periprocedural management of patients on chronic oral anticoagulant therapy: recommendations for standardized reporting of procedural\/surgical bleed risk and patient-specific thromboembolic risk","volume":"17","author":"A C Spyropoulos","year":"2019","journal-title":"J Thromb Haemost"},{"issue":"10","key":"ref13","doi-asserted-by":"crossref","first-page":"1095","DOI":"10.1001\/archinte.165.10.1095","article-title":"Systematic overview of warfarin and its drug and food interactions","volume":"165","author":"A M Holbrook","year":"2005","journal-title":"Arch Intern Med"},{"issue":"11","key":"ref14","doi-asserted-by":"crossref","first-page":"4051","DOI":"10.1111\/bcp.14833","article-title":"Drug-drug interactions with warfarin: a systematic review and meta-analysis","volume":"87","author":"M Wang","year":"2021","journal-title":"Br J Clin Pharmacol"}],"container-title":["Thrombosis and Haemostasis"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0044-1782688.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T13:57:52Z","timestamp":1730815072000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0044-1782688"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,16]]},"references-count":13,"journal-issue":{"issue":"08","published-online":{"date-parts":[[2024,7,19]]},"published-print":{"date-parts":[[2024,8]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0044-1782688","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0340-6245","2567-689X"],"issn-type":[{"value":"0340-6245","type":"print"},{"value":"2567-689X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,16]]}}}