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Daily vitamin K supplementation improves anticoagulant stability.

Abstract

BACKGROUND

One of the causes of unstable anticoagulant control in patients using vitamin K antagonists is a fluctuating intake of vitamin K. Research suggests that patients with a low dietary intake of vitamin K have a less stable anticoagulant control than patients with a higher intake.

OBJECTIVES

To study whether supplementation with a low daily dose of vitamin K improves anticoagulant control.

METHODS

We performed a double-blind, randomized, placebo-controlled trial. 200 patients of the Leiden anticoagulation clinic, who used the vitamin K antagonist phenprocoumon, were randomized to receive either adjusted-dose phenprocoumon and 100 mug vitamin K once daily or adjusted-dose phenprocoumon and a placebo. Treatment duration was 24 weeks. The primary outcome was the percentage of time the International Normalized Ratio was within the therapeutic range.

RESULTS

The time in the therapeutic range was 85.5% in the placebo group and 89.5% in the vitamin K group (adjusted difference 3.6%; 95% CI -0.8% to 8.0%). The time below the therapeutic range was 3.1% in the placebo group and 2.1% in the vitamin K group (adjusted difference -0.7%; 95% CI -2.5% to 1.1%) and the time above the therapeutic range was 11.4% in the placebo group and 8.5% in the vitamin K group (adjusted difference -2.9%; 95% CI -6.9% to 1.1%). The relative risk (RR) of a maximal stability in the vitamin K group compared to the placebo group was 1.8 (95%, CI 1.1-2.7).

CONCLUSION

Supplementation of vitamin K antagonists with 100 mug vitamin K improves stability of anticoagulant therapy. Because the risk of side effects is inversely related to anticoagulant stability, such an improvement is likely to reduce the number of bleeding and thrombotic events.

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  • Authors+Show Affiliations

    ,

    Department of Thrombosis and Haemostasis, Leiden University Medical Center, Leiden.

    ,

    Source

    MeSH

    Administration, Oral
    Aged
    Anticoagulants
    Dietary Supplements
    Double-Blind Method
    Female
    Humans
    International Normalized Ratio
    Male
    Middle Aged
    Phenprocoumon
    Placebos
    Risk
    Treatment Outcome
    Vitamin K

    Pub Type(s)

    Journal Article
    Randomized Controlled Trial

    Language

    eng

    PubMed ID

    17666020

    Citation

    Rombouts, E K., et al. "Daily Vitamin K Supplementation Improves Anticoagulant Stability." Journal of Thrombosis and Haemostasis : JTH, vol. 5, no. 10, 2007, pp. 2043-8.
    Rombouts EK, Rosendaal FR, Van Der Meer FJ. Daily vitamin K supplementation improves anticoagulant stability. J Thromb Haemost. 2007;5(10):2043-8.
    Rombouts, E. K., Rosendaal, F. R., & Van Der Meer, F. J. (2007). Daily vitamin K supplementation improves anticoagulant stability. Journal of Thrombosis and Haemostasis : JTH, 5(10), pp. 2043-8.
    Rombouts EK, Rosendaal FR, Van Der Meer FJ. Daily Vitamin K Supplementation Improves Anticoagulant Stability. J Thromb Haemost. 2007;5(10):2043-8. PubMed PMID: 17666020.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Daily vitamin K supplementation improves anticoagulant stability. AU - Rombouts,E K, AU - Rosendaal,F R, AU - Van Der Meer,F J M, Y1 - 2007/07/31/ PY - 2007/8/2/pubmed PY - 2007/12/8/medline PY - 2007/8/2/entrez SP - 2043 EP - 8 JF - Journal of thrombosis and haemostasis : JTH JO - J. Thromb. Haemost. VL - 5 IS - 10 N2 - BACKGROUND: One of the causes of unstable anticoagulant control in patients using vitamin K antagonists is a fluctuating intake of vitamin K. Research suggests that patients with a low dietary intake of vitamin K have a less stable anticoagulant control than patients with a higher intake. OBJECTIVES: To study whether supplementation with a low daily dose of vitamin K improves anticoagulant control. METHODS: We performed a double-blind, randomized, placebo-controlled trial. 200 patients of the Leiden anticoagulation clinic, who used the vitamin K antagonist phenprocoumon, were randomized to receive either adjusted-dose phenprocoumon and 100 mug vitamin K once daily or adjusted-dose phenprocoumon and a placebo. Treatment duration was 24 weeks. The primary outcome was the percentage of time the International Normalized Ratio was within the therapeutic range. RESULTS: The time in the therapeutic range was 85.5% in the placebo group and 89.5% in the vitamin K group (adjusted difference 3.6%; 95% CI -0.8% to 8.0%). The time below the therapeutic range was 3.1% in the placebo group and 2.1% in the vitamin K group (adjusted difference -0.7%; 95% CI -2.5% to 1.1%) and the time above the therapeutic range was 11.4% in the placebo group and 8.5% in the vitamin K group (adjusted difference -2.9%; 95% CI -6.9% to 1.1%). The relative risk (RR) of a maximal stability in the vitamin K group compared to the placebo group was 1.8 (95%, CI 1.1-2.7). CONCLUSION: Supplementation of vitamin K antagonists with 100 mug vitamin K improves stability of anticoagulant therapy. Because the risk of side effects is inversely related to anticoagulant stability, such an improvement is likely to reduce the number of bleeding and thrombotic events. SN - 1538-7933 UR - https://www.unboundmedicine.com/medline/citation/17666020/full_citation L2 - https://doi.org/10.1111/j.1538-7836.2007.02715.x DB - PRIME DP - Unbound Medicine ER -