Vitamin K supplementation can improve stability of anticoagulation for patients with unexplained variability in response to warfarin

Sconce, Elizabeth; Avery, Peter; Wynne, Hilary; Kamali, Farhad

doi:10.1182/blood-2006-09-049262

Cited by 161 publications

(165 citation statements)

References 33 publications

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“…In adults it has been demonstrated, in a selected group of patients on warfarin with unexplained unstable control of anticoagulation, that stability can be improved with daily supplementation of low dose vitamin K (Sconce et al, 2007). This approach to reduce the impact of day-to-day variability in dietary vitamin K intake may be beneficial in selected children but has not yet been explored.…”

Section: Warfarinmentioning

confidence: 99%

Aspects of anticoagulation in children

Payne

2010

Br J Haematol

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SummaryThe number of children receiving anticoagulation is increasing. Thromboembolic events are associated with significant risk of morbidity and mortality although the optimal management of asymptomatic events remains unclear. Specific challenges in paediatrics include the diagnosis of thrombosis, delivery and monitoring of anticoagulation in a wide range of ages from neonates through to adolescents. The development of the haemostatic system as children age results in changing pathophysiology of thrombosis and response to anticoagulation agents. Although registry and observational studies have provided vital information, specific paediatric, prospective anticoagulation studies have been few and limited in design. The result is that much of current practice is extrapolated from adult studies. Traditional anticoagulants have significant limitations. Both heparin and warfarin are in widespread use but many fundamental questions regarding dose, therapeutic range, efficacy and optimum duration have not been fully answered. Alternative agents, such as direct thrombin inhibitors and the selective anti-factor Xa inhibitor fondaparinux, may have advantages for children. Clinical trials in adults and preliminary data in children are promising but caution should be applied until specific paediatric studies have demonstrated safety and efficacy.

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Section: Warfarinmentioning

confidence: 99%

Aspects of anticoagulation in children

Payne

2010

Br J Haematol

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“…In this context, unstable anticoagulation control is related to low and erratic intake of vitamin K. 16 This can be a particular problem in older adults, who may have little home support and are less likely to be receiving balanced nutrition. In support of this concept, concomitant supplementation of vitamin K has been shown to improve anticoagulation control significantly in patients with unexplained instability of response to warfarin by reducing variability in dietary intake of vitamin K. 17 Cranberry juice has been listed as a drink to be avoided completely in those on warfarin, which is once again a myth. Zikria et al examined this in detail by analysing 15 case reports and seven clinical trials and found only two cases suggesting a 'probable' interaction, but a definite drug interaction was questionable even in these two patients.…”

Section: You Should Not Have Vitamin K-rich Foods and You Should Avoimentioning

confidence: 97%

Providing accurate information to patients who develop deep vein thrombosis

Thachil

2013

Clinical Medicine

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-Venous thromboembolism is an increasingly recognised complication in the community and in hospital in patients. Nowadays, most physicians are familiar with the algorithmic approach to the management of suspected deep vein thrombosis. However, a lack of understanding remains with regard to certain aspects of the diagnostic and treatment pathways, which has resulted in the wrong information being imparted to patients. Some of these issues are discussed in this paper, with considerations for changes in management.

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“…7,10,11 Some reports suggest that vitamin K supplementation in patients undergoing oral anticoagulant treatment should improve the stability of anticoagulation properties and protect the patient from bone damage and arterial calcifi cation. 4,8,11,12 Vitamin K may also play a protective role against agerelated bone loss. In Japan, the incidence of hip fracture is lower than in Europe and United States.…”

Section: Discussionmentioning

confidence: 99%

Oral anticoagulant treatment and risk for bone fractures in uremic hemodialysed patients

Griveas¹,

Gompou²,

Kyritsis³

et al. 2010

Dialysis & Transplantation

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Vitamin K is involved in bone metabolism, and the clinical use of vitamin K antagonists as an anticoagulant may increase the risk of bone fracture. In our renal unit, approximately 140 uremic patients were hemodialyzed. From these patients, 11 have been under anticoagulant treatment for a long time. For the last 2 years, 5 patients presented with bone fracture, and 4 of them were undergoing oral anticoagulant treatment (acenocoumarol 1 mg daily). The dose was modified according to international normalized ratio (INR) units. The use of vitamin K antagonists as anticoagulants has been considered a cause of bleeding and is related to low bone‐mineral density and a high risk of fracture. In our data, the number of patients who received oral anticoagulants (11 patients) and the number of them who presented with bone fracture (4 patients) raises the suspicion that there is an association between anticoagulant treatments and bone fractures.

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Vitamin K supplementation can improve stability of anticoagulation for patients with unexplained variability in response to warfarin

Cited by 161 publications

References 33 publications

Aspects of anticoagulation in children

Aspects of anticoagulation in children

Providing accurate information to patients who develop deep vein thrombosis

Oral anticoagulant treatment and risk for bone fractures in uremic hemodialysed patients

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