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Effect of Diseases on Response to Vitamin K Antagonists.
Curr Med Res Opin. 2015 Dec 22;:1-30
Authors: Self TH, Owens RE, Sakaan SA, Wallace JL, Sands CW, Howard-Thompson A
Abstract
INTRODUCTION: The purpose of this review article is to summarize the literature on diseases that are documented to have an effect on response to warfarin and other VKA.
METHODS: We searched the English literature from 1946 to September 2015 via PubMed, EMBASE, and Scopus for the effect of diseases on response vitamin K antagonists including warfarin, acenocoumarol, phenprocoumon, and fluindione.
DISCUSSION: Among many factors modifying response to VKA, several disease states are clinically relevant. Liver disease, hyperthyroidism, and CKD are well documented to increase response to VKA. Decompensated heart failure, fever, and diarrhea may also elevate response to VKA, but more study is needed. Hypothyroidism is associated with decreased effect of VKA, and obese patients will likely require higher initial doses of VKA.
CONCLUSION: In order to minimize risks with VKA while ensuring efficacy, clinicians must be aware of the effect of disease states when prescribing these oral anticoagulants.
PMID: 26695107 [PubMed - as supplied by publisher]