| Warfarin use and the risk of valvular calcification. | |
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MedLine Citation:
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PMID: 19793187 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Warfarin affects the synthesis and function of the matrix Gla-protein, a vitamin K-dependent protein, which is a potent inhibitor of tissue calcification. OBJECTIVES: To investigate the incidence of mitral valve calcium (MVC), mitral annular calcium (MAC) and aortic valve calcium (AVC) in patients with non-valvular atrial fibrillation (AF) treated with warfarin vs. no warfarin. PATIENTS AND METHODS: Of 1155 patients, mean age 74 years, with AF, 725 (63%) were treated with warfarin and 430 (37%) without warfarin. The incidence of MVC, MAC and AVC was investigated in these 1155 patients with two-dimensional echocardiograms. Unadjusted logistic regression analysis was conducted to examine the association between the use of warfarin and the incidence of MVC, MAC or AVC. Logistic regression analyses were also conducted to investigate whether the relationship stands after adjustment for confounding risk factors such as age, sex, race, ejection fraction, smoking, hypertension, diabetes, dyslipidemia, coronary artery disease (CAD), glomerular filtration rate, calcium, phosphorus, calcium-phosphorus product, alkaline phosphatase, use of aspirin, beta blockers, angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, and statins. RESULTS: There was a significant association between the use of warfarin and the risk of calcification [unadjusted odds ratio = 1.71, 95% CI = (1.34-2.18)]. The association still stands after adjustment for confounding risk factors. MVC, MAC or AVC was present in 473 of 725 patients (65%) on warfarin vs. 225 of 430 patients (52%) not on warfarin (P < 0.0001). Whether this is a causal relationship remains unknown. CONCLUSIONS: Use of warfarin in patients with AF is associated with an increased prevalence of MVC, MAC or AVC. |
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Authors:
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R G Lerner; W S Aronow; A Sekhri; C Palaniswamy; C Ahn; T Singh; R Sandhu; J A McClung |
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Publication Detail:
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Type: Journal Article Date: 2009-09-28 |
Journal Detail:
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Title: Journal of thrombosis and haemostasis : JTH Volume: 7 ISSN: 1538-7836 ISO Abbreviation: J. Thromb. Haemost. Publication Date: 2009 Dec |
Date Detail:
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Created Date: 2009-12-18 Completed Date: 2010-03-02 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101170508 Medline TA: J Thromb Haemost Country: England |
Other Details:
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Languages: eng Pagination: 2023-7 Citation Subset: IM |
Affiliation:
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Division of Cardiology, Department of Medicine, New York Medical College, Valhalla, NY 10595, USA. ROBERT_LERNER@nymc.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aged, 80 and over Aortic Valve / pathology* Atrial Fibrillation / complications, drug therapy Calcinosis / chemically induced* Calcium-Binding Proteins / biosynthesis, physiology Extracellular Matrix Proteins / biosynthesis, physiology Female Humans Male Middle Aged Mitral Valve / pathology* Regression Analysis Retrospective Studies Risk Risk Factors Warfarin / adverse effects*, therapeutic use |
| Chemical | |
Reg. No./Substance:
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0/Calcium-Binding Proteins; 0/Extracellular Matrix Proteins; 0/matrix Gla protein; 81-81-2/Warfarin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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