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Structure and mechanics of fibrin clots formed under mechanical perturbation
Author(s) -
MÜnster S.,
Jawerth L. M.,
Fabry B.,
Weitz D. A.
Publication year - 2013
Publication title -
journal of thrombosis and haemostasis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.947
H-Index - 178
eISSN - 1538-7836
pISSN - 1538-7933
DOI - 10.1111/jth.12123
Subject(s) - fibrin , perturbation (astronomy) , classical mechanics , mechanics , medicine , physics , quantum mechanics , immunology
darone withdrawal can lead to under-anticoagulation, and therefore to an increased risk of thrombosis. In conclusion, we describe the first case of genetic VKA resistance in a child who had the p.Asp36Tyr mutation combined with g. 1185G>A and g. 679A>G mutations in the 5′-flanking region. VKA resistance was partially masked initially by concomitant amiodarone therapy. Both warfarin–drug interactions and genetic variations should be considered in the management of VKA therapy. Physicians should be aware that potentially interfering drugs can increase or decrease the INR when they are introduced or withdrawn in patients on warfarin therapy. Close INR monitoring is advisable in such situations. Pharmacodynamic VKA resistance resulting from genetic factors may be masked by concomitant drugs.