scholarly journals Gut Microbiota and the Quality of Oral Anticoagulation in Vitamin K Antagonists Users: A Review of Potential Implications

2021 ◽  
Vol 10 (4) ◽  
pp. 715
Author(s):  
Anny Camelo-Castillo ◽  
José Miguel Rivera-Caravaca ◽  
Esteban Orenes-Piñero ◽  
Inmaculada Ramírez-Macías ◽  
Vanessa Roldán ◽  
...  
Keyword(s):  
Gut Microbiota ◽  
Vitamin K ◽  
Vitamin K Antagonists ◽  
Oral Anticoagulants ◽  
Individual Variability ◽  
Future Research ◽  
The Mean ◽  
Anticoagulation Control ◽  
Mean Time

The efficacy and safety of vitamin K antagonists (VKAs) as oral anticoagulants (OACs) depend on the quality of anticoagulation control, as reflected by the mean time in therapeutic range (TTR). Several factors may be involved in poor TTR such as comorbidities, high inter-individual variability, interacting drugs, and non-adherence. Recent studies suggest that gut microbiota (GM) plays an important role in the pathogenesis of cardiovascular diseases, but the effect of the GM on anticoagulation control with VKAs is unknown. In the present review article, we propose different mechanisms by which the GM could have an impact on the quality of anticoagulation control in patients taking VKA therapy. We suggest that the potential effects of GM may be mediated first, by an indirect effect of metabolites produced by GM in the availability of VKAs drugs; second, by an effect of vitamin K-producing bacteria; and finally, by the structural modification of the molecules of VKAs. Future research will help confirm these hypotheses and may suggest profiles of bacterial signatures or microbial metabolites, to be used as biomarkers to predict the quality of anticoagulation. This could lead to the design of intervention strategies modulating gut microbiota, for example, by using probiotics.

Evaluation of the SAMe-TT2R2 score to predict the quality of anticoagulation control in patients with venous thromboembolism treated with vitamin K antagonists: Findings from the RIETE registry

2020 ◽  
Vol 194 ◽  
pp. 178-182
Author(s):  
Jorge del-Toro-Cervera ◽  
Pablo Demelo-Rodriguez ◽  
Francisco Galeano-Valle ◽  
Ángeles Fidalgo ◽  
Ángel Sampériz ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Vitamin K ◽  
Vitamin K Antagonists ◽  
Anticoagulation Control

scholarly journals New Oral Anticoagulants vs Vitamin K Antagonists: Benefits for Health-Related Quality of Life in Patients with Atrial Fibrillation

2014 ◽  
Vol 11 (7) ◽  
pp. 680-684 ◽  
Author(s):  
Josep M. Alegret ◽  
Xavier Viñolas ◽  
Miguel A. Arias ◽  
Antoni Martínez-Rubio ◽  
Pablo Rebollo ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Atrial Fibrillation ◽  
Vitamin K ◽  
Vitamin K Antagonists ◽  
Oral Anticoagulants ◽  
New Oral Anticoagulants ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

scholarly journals Quality of Chronic Anticoagulation Control in Patients with Intracranial Haemorrhage due to Vitamin K Antagonists

2018 ◽  
Vol 2018 ◽  
pp. 1-6
Author(s):  
Carlos Estevez-Fraga ◽  
Maria Molina-Sanchez ◽  
Rodrigo Alvarez-Velasco ◽  
Pablo Agüero-Rabes ◽  
Leticia Crespo-Araico ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Vitamin K ◽  
Stroke Unit ◽  
Intracranial Haemorrhage ◽  
Vitamin K Antagonists ◽  
Prosthetic Valves ◽  
Increased Risk ◽  
Study Population ◽  
Anticoagulation Control

Introduction. Patients treated with vitamin K antagonists (VKA) are at increased risk of intracranial haemorrhage (ICH). The purpose of our study was to determine the quality of previous anticoagulation control in patients with VKA-associated ICH. Materials and Methods. We prospectively assessed every consecutive patient admitted to our stroke unit with VKA-associated ICH between 2013 and 2016. Demographic, clinical, and radiological variables, as well as consecutive international normalized ratios (INR) during 7 previous months, were extracted. Time in therapeutic range (TTR), time over range (TOR), time below range (TBR), and percentage of INR within range (PINRR) were calculated. Results and Discussion. The study population comprised 53 patients. Mean age was 79 years; 42% were women. Forty-eight patients had atrial fibrillation (AF) and 5 mechanical prosthetic valves. Therapeutic or infratherapeutic INR on arrival was detected in 64.4% of patients (95% CI 2.7 to 3.2). TTR was 67.8% (95% CI: 60.2 to 75.6 %) and PINRR was 75% (95% CI: 49.9-100). TOR was 17.2% (95% CI: 10.4 to 23.9% ) and TBR was 17% (95% CI: 10.6 to 23.9%). Conclusion. VKA-associated ICH happens usually in the context of good chronic anticoagulation control. Newer risk assessment methods are required.

Ethnicity and cardiac arrhythmias

ESC CardioMed ◽  
2018 ◽  
pp. 2898-2902
Author(s):  
Tatjana Potpara
Keyword(s):  
African Americans ◽  
Ethnic Groups ◽  
Vitamin K ◽  
Cardiac Arrhythmias ◽  
Vitamin K Antagonists ◽  
Oral Anticoagulants ◽  
Efficacy And Safety ◽  
Asian Patients ◽  
Therapeutic Anticoagulation

Certain cardiac arrhythmias are characterized by various ethnicity-related diversities in epidemiology, patient risk profiles, disease burden, treatment, or outcomes. Although the prevalence of conventional cardiovascular risk factors is generally greater in non-Caucasian ethnic groups, the risk for atrial fibrillation (AF) is higher in Caucasians. However, Caucasians are less vulnerable to AF-associated morbidity and mortality compared to other ethnic groups (the so-called AF ethnical paradox). Asian patients with AF are particularly sensitive to vitamin K antagonists, while non-vitamin K antagonist oral anticoagulants (NOACs) offer better efficacy and safety in Asian than non-Asian patients. African Americans require higher warfarin doses to maintain therapeutic anticoagulation intensity, and the quality of warfarin management is lower compared to white patients. Data on the effects of NOACs in African Americans and Hispanics are limited, since they were underrepresented in the landmark NOAC trials.

scholarly journals Evaluation of SAMe-TT2R2 risk score for predicting the quality of anticoagulation control in a real-world cohort of patients with non-valvular atrial fibrillation on vitamin-K antagonists

EP Europace ◽  
2015 ◽  
Vol 17 (5) ◽  
pp. 711-717 ◽  
Author(s):  
R. R.-Y. Abumuaileq ◽  
E. Abu-Assi ◽  
S. Raposeiras-Roubin ◽  
A. Lopez-Lopez ◽  
A. Redondo-Dieguez ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Risk Score ◽  
Vitamin K ◽  
Real World ◽  
Vitamin K Antagonists ◽  
Anticoagulation Control
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