Possible Correlation between INR and Serum Calcium

Helin, Tuukka; Wickholm, Niko; Kautiainen, Hannu; Vapaatalo, Heikki

doi:10.4236/pp.2014.513129

Cited by 2 publications

(2 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In these previous experiments, the effects of menaquinone were postulated to be mediated via the osteoprotegerin gene participating in calcification. In a clinical material [21] using laboratory data, we found correlation (adjusted on age and sex) between warfarin anticoagulation (INR values) and serum calcium (corrected with albumin). The negative correlation between these two variables, high INR (high warfarin dose) and low serum calcium (accumulation in soft tissues or increased urinary excretion) is evidence of some association between warfarin therapy and calcium metabolism in bone.…”

Section: Possibilities To Prevent Calcificationmentioning

confidence: 88%

See 1 more Smart Citation

Vascular Calcification, Vitamin K and Warfarin Therapy – Possible or Plausible Connection?

Siltari

Vapaatalo

2017

Basic Clin Pharma Tox

Self Cite

View full text Add to dashboard Cite

Atherosclerosis is a pathological process underpinning many cardiovascular diseases; it is the main cause of global mortality. Atherosclerosis is characterized by an invasion of inflammatory cells, accumulation of lipids and the formation of fatty streaks (plaques) which subsequently allow accumulation of calcium and other minerals leading to a disturbance in the vascular endothelium and its regulatory role in arterial function. Vascular calcification is a different process, stringently regulated mainly by local factors, in which osteoblast-like cells accumulate in the muscular layer of arteries ultimately taking on the physiological appearance of bone. The elevated stiffness of the arteries leads to severe vascular complications in brain, heart and kidneys. Recently, evidence from animal experiments as well as clinical and epidemiological results suggests that long-term treatment with warfarin, but not with the novel direct anticoagulants, can increase the risk or even induce vascular calcification in some individuals. Gamma-carboxylation is an enzymatic process not only needed for activation of vitamin K but also other proteins which participate in bone formation and vascular calcification. Thus, reduced expression of the vitamin K-dependent proteins which physiologically inhibit calcification of cellular matrix could be postulated to lead to vascular calcification. Published clinical data, describing at present a few thousand patients, need to be supplemented with controlled studies to confirm this interesting hypothesis.

show abstract

Section: Possibilities To Prevent Calcificationmentioning

confidence: 88%

“…In recent years, several reviews on warfarin‐induced vascular calcification have been published . Our research group became also interested in this possible interaction and reported experimental and clinical data on this topic .…”

Section: Vascular Calcificationmentioning

confidence: 99%

Vascular Calcification, Vitamin K and Warfarin Therapy – Possible or Plausible Connection?

Siltari

Vapaatalo

2017

Basic Clin Pharma Tox

Self Cite

View full text Add to dashboard Cite

show abstract

Therapeutic warfarin use and the extrahepatic functions of vitamin K-dependent proteins

Donaldson

Harrington

2017

British Journal of Biomedical Science

View full text Add to dashboard Cite

The impact of warfarin therapy on the functions of extrahepatic vitamin K-dependent proteins (VKDP) is less clearly understood and less widely recognised in clinical practice than that on the hepatic counterparts (clotting factors II, VII, IX and X). Warfarin inhibits osteocalcin, an abundant extrahepatic VKDP involved in the mineralisation and maturation of bone and thus, primarily by this mechanism, may have an adverse effect on bone health. Whilst some studies do link warfarin use to an increase in osteoporosis and fracture risk others have not. Warfarin also inhibits the extrahepatic VKDP matrix gla protein (MGP) which acts to prevent ectopic calcification of the vasculature. Studies have consistently found a correlation between warfarin use and vascular calcification with inhibition of MGP believed to be the main cause. Inhibition of MGP also appears to explain warfarin's well established teratogenic effect. Further adverse effects may also arise from warfarin's inhibition of other known extrahepatic VKDPs. The available evidence is intriguing, and suggests that the impact of warfarin on the extrahepatic functions of vitamin K-dependent proteins warrants further careful consideration.

show abstract

Possible Correlation between INR and Serum Calcium

Cited by 2 publications

References 24 publications

Vascular Calcification, Vitamin K and Warfarin Therapy – Possible or Plausible Connection?

Vascular Calcification, Vitamin K and Warfarin Therapy – Possible or Plausible Connection?

Therapeutic warfarin use and the extrahepatic functions of vitamin K-dependent proteins

Contact Info

Product

Resources

About