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Long-term warfarin therapy and biomarkers for osteoporosis and atherosclerosis
BACKGROUND: Stroke prevention by warfarin, a vitamin K antagonist, has been an integral part in the management of atrial fibrillation. Vitamin K-dependent matrix Gla protein (MGP) has been known as a potent inhibitor of arterial calcification and osteoporosis. Therefore, we hypothesized that warfari...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4661704/ https://www.ncbi.nlm.nih.gov/pubmed/26674156 http://dx.doi.org/10.1016/j.bbacli.2015.08.002 |
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author | Namba, Sayaka Yamaoka-Tojo, Minako Hashikata, Takehiro Ikeda, Yuki Kitasato, Lisa Hashimoto, Takuya Shimohama, Takao Tojo, Taiki Takahira, Naonobu Masuda, Takashi Ako, Junya |
author_facet | Namba, Sayaka Yamaoka-Tojo, Minako Hashikata, Takehiro Ikeda, Yuki Kitasato, Lisa Hashimoto, Takuya Shimohama, Takao Tojo, Taiki Takahira, Naonobu Masuda, Takashi Ako, Junya |
author_sort | Namba, Sayaka |
collection | PubMed |
description | BACKGROUND: Stroke prevention by warfarin, a vitamin K antagonist, has been an integral part in the management of atrial fibrillation. Vitamin K-dependent matrix Gla protein (MGP) has been known as a potent inhibitor of arterial calcification and osteoporosis. Therefore, we hypothesized that warfarin therapy affects bone mineral metabolism, vascular calcification, and vascular endothelial dysfunction. METHODS: We studied 42 atrial fibrillation patients at high-risk for atherosclerosis having one or more coronary risk factors. Twenty-four patients had been treated with warfarin for at least 12 months (WF group), and 18 patients without warfarin (non-WF group). Bone alkaline phosphatase (BAP) and under carboxylated osteocalcin (ucOC) and receptor activator of nuclear factor-kappa B ligand (RANKL) were measured as bone metabolism markers. Reactive hyperemia-peripheral arterial tonometry (RH-PAT) index measured by Endo-PAT2000 was used as an indicator of vascular endothelial function. RESULTS: There were no significant differences in patient background characteristics and other clinical indicators between the two groups. In WF group, the ucOC levels were significantly higher than those in the non-WF group (10.3 ± 0.8 vs. 3.4 ± 0.9 ng/mL; P < 0.01), similarly, the RANKL levels in the WF group were higher than those in the non-WF group (0.60 ± 0.06 vs. 0.37 ± 0.05 ng/mL; P = 0.007). Moreover, RH-PAT index was significantly lower in the WF group compared to those in the non-WF group (1.48 ± 0.11 vs. 1.88 ± 0.12; P = 0.017). CONCLUSIONS: Long-term warfarin therapy may be associated with bone mineral loss and vascular calcification in 60–80 year old hypertensive patients. |
format | Online Article Text |
id | pubmed-4661704 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-46617042015-12-15 Long-term warfarin therapy and biomarkers for osteoporosis and atherosclerosis Namba, Sayaka Yamaoka-Tojo, Minako Hashikata, Takehiro Ikeda, Yuki Kitasato, Lisa Hashimoto, Takuya Shimohama, Takao Tojo, Taiki Takahira, Naonobu Masuda, Takashi Ako, Junya BBA Clin Regular Article BACKGROUND: Stroke prevention by warfarin, a vitamin K antagonist, has been an integral part in the management of atrial fibrillation. Vitamin K-dependent matrix Gla protein (MGP) has been known as a potent inhibitor of arterial calcification and osteoporosis. Therefore, we hypothesized that warfarin therapy affects bone mineral metabolism, vascular calcification, and vascular endothelial dysfunction. METHODS: We studied 42 atrial fibrillation patients at high-risk for atherosclerosis having one or more coronary risk factors. Twenty-four patients had been treated with warfarin for at least 12 months (WF group), and 18 patients without warfarin (non-WF group). Bone alkaline phosphatase (BAP) and under carboxylated osteocalcin (ucOC) and receptor activator of nuclear factor-kappa B ligand (RANKL) were measured as bone metabolism markers. Reactive hyperemia-peripheral arterial tonometry (RH-PAT) index measured by Endo-PAT2000 was used as an indicator of vascular endothelial function. RESULTS: There were no significant differences in patient background characteristics and other clinical indicators between the two groups. In WF group, the ucOC levels were significantly higher than those in the non-WF group (10.3 ± 0.8 vs. 3.4 ± 0.9 ng/mL; P < 0.01), similarly, the RANKL levels in the WF group were higher than those in the non-WF group (0.60 ± 0.06 vs. 0.37 ± 0.05 ng/mL; P = 0.007). Moreover, RH-PAT index was significantly lower in the WF group compared to those in the non-WF group (1.48 ± 0.11 vs. 1.88 ± 0.12; P = 0.017). CONCLUSIONS: Long-term warfarin therapy may be associated with bone mineral loss and vascular calcification in 60–80 year old hypertensive patients. Elsevier 2015-08-12 /pmc/articles/PMC4661704/ /pubmed/26674156 http://dx.doi.org/10.1016/j.bbacli.2015.08.002 Text en © 2015 The Author http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Regular Article Namba, Sayaka Yamaoka-Tojo, Minako Hashikata, Takehiro Ikeda, Yuki Kitasato, Lisa Hashimoto, Takuya Shimohama, Takao Tojo, Taiki Takahira, Naonobu Masuda, Takashi Ako, Junya Long-term warfarin therapy and biomarkers for osteoporosis and atherosclerosis |
title | Long-term warfarin therapy and biomarkers for osteoporosis and atherosclerosis |
title_full | Long-term warfarin therapy and biomarkers for osteoporosis and atherosclerosis |
title_fullStr | Long-term warfarin therapy and biomarkers for osteoporosis and atherosclerosis |
title_full_unstemmed | Long-term warfarin therapy and biomarkers for osteoporosis and atherosclerosis |
title_short | Long-term warfarin therapy and biomarkers for osteoporosis and atherosclerosis |
title_sort | long-term warfarin therapy and biomarkers for osteoporosis and atherosclerosis |
topic | Regular Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4661704/ https://www.ncbi.nlm.nih.gov/pubmed/26674156 http://dx.doi.org/10.1016/j.bbacli.2015.08.002 |
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