Hyperhomocysteinemia and B-vitamin status after discontinuation of oral anticoagulation therapy in patients with a history of venous thromboembolism
Hyperhomocysteinemia and B-vitamin status after discontinuation of oral anticoagulation therapy in patients with a history of venous thromboembolism
Although hyperhomocysteinemia is an established risk factor for venous thromboembolism there is no consensus for routine determination of circulating homocysteine in the UK, either at the beginning or end of oral anticoagulation therapy. The purpose of this study was to evaluate the prevalence of hyperhomocysteinemia and its relationship to folate and vitamin B12 status in subjects with venous thromboembolism 4 weeks after discontinuation of warfarin therapy. In 78 consecutively recruited patients, plasma homocysteine was significantly higher (p < 0.001) and red cell folate significantly lower (p = 0.03) than in controls. Plasma vitamin B12 was similar in both groups. Strikingly, 38.5% of patients had hyperhomocysteinemia (> 15 micromol/l). Retrospective analysis revealed a significant positive association between plasma total homocysteine and duration of warfarin therapy (p < 0.001) but a negative, though non-significant (p = 0.06), trend with warfarin dose. The results do not suggest any direct interaction between warfarin and plasma homocysteine but raise the possibility of reduced intake of a common food source of folate and vitamin K. One possibility is the shortage of green-leafy vegetables since patients are often advised to limit their intake of this major source of vitamin K. On the basis of this study we suggest that homocysteine screening should be carried out at the time that patients begin warfarin therapy.
Administration, Oral, Adult, Aged, Aged, 80 and over, Anticoagulants/administration & dosage, Female, Folic Acid/blood, Genotype, Homocysteine/blood, Humans, Hyperhomocysteinemia/blood, Male, Methylenetetrahydrofolate Reductase (NADPH2)/genetics, Middle Aged, Retrospective Studies, Substance Withdrawal Syndrome, Thromboembolism/blood, Vitamin B 12/blood, Warfarin/administration & dosage
1493-1497
Sobczyńska-Malefora, Agata
8887e6df-c8e4-4b94-8788-a9645c421627
Harrington, Dominic J
efa56037-894f-4305-8245-1f67ee4896e3
Rangarajan, Savita
9a5e4c7e-55ba-4a3a-b5f6-f1e269d927c3
Kovacs, Jo-Anne
63fe5d15-db5d-42e7-9694-a914c07e50aa
Shearer, Martin J
c3211e4e-dbcd-4780-a952-867dac2cf862
Savidge, Geoffrey F
f4f07452-f896-4b98-b929-5bbee3bff8a8
November 2003
Sobczyńska-Malefora, Agata
8887e6df-c8e4-4b94-8788-a9645c421627
Harrington, Dominic J
efa56037-894f-4305-8245-1f67ee4896e3
Rangarajan, Savita
9a5e4c7e-55ba-4a3a-b5f6-f1e269d927c3
Kovacs, Jo-Anne
63fe5d15-db5d-42e7-9694-a914c07e50aa
Shearer, Martin J
c3211e4e-dbcd-4780-a952-867dac2cf862
Savidge, Geoffrey F
f4f07452-f896-4b98-b929-5bbee3bff8a8
Sobczyńska-Malefora, Agata, Harrington, Dominic J, Rangarajan, Savita, Kovacs, Jo-Anne, Shearer, Martin J and Savidge, Geoffrey F
(2003)
Hyperhomocysteinemia and B-vitamin status after discontinuation of oral anticoagulation therapy in patients with a history of venous thromboembolism.
Clinical Chemistry and Laboratory Medicine, 41 (11), .
(doi:10.1515/CCLM.2003.229).
Abstract
Although hyperhomocysteinemia is an established risk factor for venous thromboembolism there is no consensus for routine determination of circulating homocysteine in the UK, either at the beginning or end of oral anticoagulation therapy. The purpose of this study was to evaluate the prevalence of hyperhomocysteinemia and its relationship to folate and vitamin B12 status in subjects with venous thromboembolism 4 weeks after discontinuation of warfarin therapy. In 78 consecutively recruited patients, plasma homocysteine was significantly higher (p < 0.001) and red cell folate significantly lower (p = 0.03) than in controls. Plasma vitamin B12 was similar in both groups. Strikingly, 38.5% of patients had hyperhomocysteinemia (> 15 micromol/l). Retrospective analysis revealed a significant positive association between plasma total homocysteine and duration of warfarin therapy (p < 0.001) but a negative, though non-significant (p = 0.06), trend with warfarin dose. The results do not suggest any direct interaction between warfarin and plasma homocysteine but raise the possibility of reduced intake of a common food source of folate and vitamin K. One possibility is the shortage of green-leafy vegetables since patients are often advised to limit their intake of this major source of vitamin K. On the basis of this study we suggest that homocysteine screening should be carried out at the time that patients begin warfarin therapy.
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Published date: November 2003
Keywords:
Administration, Oral, Adult, Aged, Aged, 80 and over, Anticoagulants/administration & dosage, Female, Folic Acid/blood, Genotype, Homocysteine/blood, Humans, Hyperhomocysteinemia/blood, Male, Methylenetetrahydrofolate Reductase (NADPH2)/genetics, Middle Aged, Retrospective Studies, Substance Withdrawal Syndrome, Thromboembolism/blood, Vitamin B 12/blood, Warfarin/administration & dosage
Identifiers
Local EPrints ID: 443328
URI: http://eprints.soton.ac.uk/id/eprint/443328
ISSN: 1434-6621
PURE UUID: 574475bd-1fe9-434f-9ad2-a01cef718101
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Date deposited: 20 Aug 2020 16:33
Last modified: 17 Mar 2024 04:02
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Author:
Agata Sobczyńska-Malefora
Author:
Dominic J Harrington
Author:
Jo-Anne Kovacs
Author:
Martin J Shearer
Author:
Geoffrey F Savidge
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