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Impact of regular physical activity on weekly warfarin dose requirement
Warfarin is an oral anticoagulant agent with a narrow therapeutic index. There is a marked inter- and intra-patient variability in warfarin dose requirement. All factors influencing warfarin response are not known and this study aims to evaluate if regular physical activity (RPA) is a determining fa...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer US
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4735233/ https://www.ncbi.nlm.nih.gov/pubmed/26238769 http://dx.doi.org/10.1007/s11239-015-1248-9 |
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author | Rouleau-Mailloux, Étienne Shahabi, Payman Dumas, Stéphanie Feroz Zada, Yassamin Provost, Sylvie Hu, Jason Nguyen, Jacqueline Bouchama, Nawal Mongrain, Ian Talajic, Mario Tardif, Jean-Claude Perreault, Sylvie Dubé, Marie-Pierre |
author_facet | Rouleau-Mailloux, Étienne Shahabi, Payman Dumas, Stéphanie Feroz Zada, Yassamin Provost, Sylvie Hu, Jason Nguyen, Jacqueline Bouchama, Nawal Mongrain, Ian Talajic, Mario Tardif, Jean-Claude Perreault, Sylvie Dubé, Marie-Pierre |
author_sort | Rouleau-Mailloux, Étienne |
collection | PubMed |
description | Warfarin is an oral anticoagulant agent with a narrow therapeutic index. There is a marked inter- and intra-patient variability in warfarin dose requirement. All factors influencing warfarin response are not known and this study aims to evaluate if regular physical activity (RPA) is a determining factor. RPA level was collected with the Stanford Brief Activity Survey in 1064 incident warfarin users, as part of the Quebec Warfarin Cohort (QWC), and with the Global Physical Activity Questionnaire in 618 patients from the Montreal Heart Institute (MHI) Biobank. Linear regression was performed to model relationship of warfarin dose after 3 months of therapy in the QWC with RPA, while controlling for height, weight, age, CYP2C9 (*2 and *3 alleles) and VKORC1 (*2 allele) genotype. Warfarin dose of prevalent users was modeled in the MHI Biobank for replication. A higher level of physical activity was associated with higher doses of warfarin in both cohorts. In the QWC, physical activity could explain 5.4 % (P < 0.001) and 0.9 % (P = 3.23 × 10(−5)) of variance in dose, in univariate and multivariable models, respectively. Similarly, RPA was found to be associated with 1.7 % (P = 0.0012) and 0.5 % (P = 0.0391) of inter-individual variability in warfarin dose requirement before and after adjustment for other covariables, respectively. RPA is associated with higher warfarin dose requirement. The relevance of clinical recommendations on RPA to maintain a steady response to warfarin should be assessed in further studies. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s11239-015-1248-9) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-4735233 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Springer US |
record_format | MEDLINE/PubMed |
spelling | pubmed-47352332016-02-09 Impact of regular physical activity on weekly warfarin dose requirement Rouleau-Mailloux, Étienne Shahabi, Payman Dumas, Stéphanie Feroz Zada, Yassamin Provost, Sylvie Hu, Jason Nguyen, Jacqueline Bouchama, Nawal Mongrain, Ian Talajic, Mario Tardif, Jean-Claude Perreault, Sylvie Dubé, Marie-Pierre J Thromb Thrombolysis Article Warfarin is an oral anticoagulant agent with a narrow therapeutic index. There is a marked inter- and intra-patient variability in warfarin dose requirement. All factors influencing warfarin response are not known and this study aims to evaluate if regular physical activity (RPA) is a determining factor. RPA level was collected with the Stanford Brief Activity Survey in 1064 incident warfarin users, as part of the Quebec Warfarin Cohort (QWC), and with the Global Physical Activity Questionnaire in 618 patients from the Montreal Heart Institute (MHI) Biobank. Linear regression was performed to model relationship of warfarin dose after 3 months of therapy in the QWC with RPA, while controlling for height, weight, age, CYP2C9 (*2 and *3 alleles) and VKORC1 (*2 allele) genotype. Warfarin dose of prevalent users was modeled in the MHI Biobank for replication. A higher level of physical activity was associated with higher doses of warfarin in both cohorts. In the QWC, physical activity could explain 5.4 % (P < 0.001) and 0.9 % (P = 3.23 × 10(−5)) of variance in dose, in univariate and multivariable models, respectively. Similarly, RPA was found to be associated with 1.7 % (P = 0.0012) and 0.5 % (P = 0.0391) of inter-individual variability in warfarin dose requirement before and after adjustment for other covariables, respectively. RPA is associated with higher warfarin dose requirement. The relevance of clinical recommendations on RPA to maintain a steady response to warfarin should be assessed in further studies. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s11239-015-1248-9) contains supplementary material, which is available to authorized users. Springer US 2015-08-04 2016 /pmc/articles/PMC4735233/ /pubmed/26238769 http://dx.doi.org/10.1007/s11239-015-1248-9 Text en © The Author(s) 2015 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
spellingShingle | Article Rouleau-Mailloux, Étienne Shahabi, Payman Dumas, Stéphanie Feroz Zada, Yassamin Provost, Sylvie Hu, Jason Nguyen, Jacqueline Bouchama, Nawal Mongrain, Ian Talajic, Mario Tardif, Jean-Claude Perreault, Sylvie Dubé, Marie-Pierre Impact of regular physical activity on weekly warfarin dose requirement |
title | Impact of regular physical activity on weekly warfarin dose requirement |
title_full | Impact of regular physical activity on weekly warfarin dose requirement |
title_fullStr | Impact of regular physical activity on weekly warfarin dose requirement |
title_full_unstemmed | Impact of regular physical activity on weekly warfarin dose requirement |
title_short | Impact of regular physical activity on weekly warfarin dose requirement |
title_sort | impact of regular physical activity on weekly warfarin dose requirement |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4735233/ https://www.ncbi.nlm.nih.gov/pubmed/26238769 http://dx.doi.org/10.1007/s11239-015-1248-9 |
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