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The influence of (R)- and (S)-Warfarin, vitamin K and vitamin K epoxide upon warfarin anticoagulation

Lookup NU author(s): Professor Farhad Kamali, Dr Tim Butler, Dr Hilary Wynne

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Abstract

The contribution of (R)- and (S)-warfarin enantiomers, vitamin K and vitamin K epoxide and patient factors to inter-individual variability in daily warfarin requirements were examined in a group of 73 patients. Simple correlation analysis showed a significant positive relationship between INR values and plasma (S)-warfarin concentrations (r = 0.25; p = 0.038). Multivariate analysis for relationships with INR demonstrated a highly significant positive relationship between INR and (S)-warfarin (p = 0.004) and plasma vitamin K epoxide concentrations (p = 0.028), and a significant negative relationship between INR and plasma vitamin K concentrations (p = 0.034). Twenty five percent of variation in INR could be explained by these variables (adjusted R2 = 0.25). Correlation analysis of data showed that warfarin dosage was significantly and negatively correlated with patient age (r = -0.42; p < 0.0001). Patient age accounted for 25% of variation in warfarin dosage requirements (R2 = 0.25). The combined effects of age and vitamin K appear to account for much of the inter-individual variability in warfarin dosage requirements.


Publication metadata

Author(s): Butler TJ; Kamali F; Wynne HA; Edwards C

Publication type: Article

Publication status: Published

Journal: Thrombosis and Haemostasis

Year: 2000

Volume: 84

Issue: 1

Pages: 39-42

ISSN (print): 0340-6245

ISSN (electronic):

Publisher: Schattauer GmbH

URL: http://www.ncbi.nlm.nih.gov/pubmed/10928467

PubMed id: 10928467


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