A Cohort Study of Warfarin Administered to Achieve An INR of 2.0 to 3.0 for the Prevention of Recurrent Venous Thrombosis in Patients with An Antiphospholipid Antibody.
Bibliographic record
Abstract
Abstract Abstract 3123 Poster Board III-60 Introduction Despite recent evidence, controversy remains regarding the optimal method of recurrent thrombosis prevention in patients with antiphospholipid antibodies (APLA) and prior thrombosis. Specifically, although two randomized trials have supported the efficacy of “usual intensity warfarin” (administered to a target INR of 2.0 to 3.0) there remains a dearth of prospective data examining this treatment. The aim of our study was to confirm that patients with prior thrombosis and an APLA had a low risk of recurrent thrombosis while being treated with warfarin administered to achieve an INR of 2.0 to 3.0. Methods We examined the annual rate of recurrent thrombosis in patients with prior thrombosis and APLA who had all been treated with OAT (oral anticoagulant therapy) to achieve a target INR of 2.0 to 3.0. Eligible patients had to have had at least one prior objectively confirmed arterial or venous thrombosis and at least one positive standardized test for an APLA. Patients were selected from the Victoria Hospital, and follow up appointments were conducted through the hospital's thrombosis clinic. Consenting patients underwent a baseline clinical examination with the intent to be followed every six months for evidence of recurrent thrombosis, adverse consequences of anticoagulation therapy, or until death. Results Eighty three patients (mean age 50.5 years; 50 females) were enrolled; one patient was lost to follow up and did not contribute data to the analyses. Median follow up was 12 months (Range 5-18 months). No patients experienced a recurrent thrombotic event. 10 patients (12.2%) had a minor bleeding event (5 had significant ecchymosis, two had rectal bleeding, two had vaginal bleeding, and one had hematuria). No major bleeding events occurred. One patient had a presumed transient ischemic attack (TIA). One patient (1.2%) died during follow up due to multi-system organ failure in the context of a failing hepatic allograft. Conclusion Patients with previous thrombosis and an APLA have a low risk of recurrent thrombosis while having a target INR of 2.0 to 3.0. “Usual intensity warfarin” therapy appears to be an adequate method of thromboprophylaxis in these patients. Disclosures Crowther: BI: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; Bayer: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; Pfizer: Consultancy, Honoraria, Research Funding; Leo Pharma: Consultancy, Honoraria, Research Funding; Sanofi-Aventis: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; Artisan Pharma: Consultancy, Membership on an entity's Board of Directors or advisory committees.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".