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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...

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Autores principales: Namba, Sayaka, Yamaoka-Tojo, Minako, Hashikata, Takehiro, Ikeda, Yuki, Kitasato, Lisa, Hashimoto, Takuya, Shimohama, Takao, Tojo, Taiki, Takahira, Naonobu, Masuda, Takashi, Ako, Junya
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2015
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.
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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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