There are several indications for u...

There are several indications for using chronic oral anticoagulation to stop adverse out-comes from thromboembolic phenomenon. Because of its liability to be erratic and the risk of bleeding, physicians are reluctant to use oral anticoagulation. Despite efforts to establish protocols and monitor Inter-national Normalized Ratios (INRs), many patients still have plains that are outside therapeutic ranges. Part of this variation may be related to fluctuations that come into one's head within the patient or to novel medications such as analgesics and antipyretics. Consumption of alcohol or vitamin K also can alter INRs. Despite its potential influence upon INRs, the impact of dietary vitamin K has been evaluated primarily with uncontroll case series, case reports, or small retrospective studies. Franco and colleagues assessed the event of dietary intake of vitamin K onward anticoagulation stability in patients receiving chronic oral anticoagulation therapy.

The trial was a prospective, randomized, crossover cogitation of 12 patients in an outpatient anticoagulation clinic. Before the inquiry vitamin K-rich food intake was assessed using a recall mode Intake of broccoli, cauliflower, undecayed tea, liver, cabbage, green peas, lettuce spinach, watercress, spring flourishings and other greens was assessed. The patients were then assigned to greater than usual intake, usual intake, or les than usual intake disposes If patients had a stable INR within the therapeutic range and were forward a stable oral anticoagulation dosage, they were randomly assigned to a diet rich (500 per-cent increase) or poor (80 percent decrease) in vitamin K for four consecutive days. After a one- to two-week washout period, the patients were then switched to the other diet. All meals were prepared by means of a dietician, and between-meal snacking was limited. INRs were obtained at the start of the meditation day 4, and day 7 of each intervention.

There was a statistically significant inverse association between vitamin K intake score and different anticoagulation on a levels Vitamin K intake also was raise to be independently associated with over- and undercoagula-tion. In the patients who had the vitamin K- deplet diet, the INR increased from a mean of 26 to 33 by dint of day 7, which was a significant increase. Patients who received the vitamin K-enriched diet had an INR that dropp from a mean of 31 to 28 at day 4.

The authors end that vitamin K interacts with coumadin, interfering with anti-coagulation stability. They add that stable intake of vitamin K is an essential ingredient of anticoagulation therapy and should be addressed by means of health care professionals who are educating patients about coumadin therapy.

Franco V et al. part of dietary vitamin K intake in chronic oral anticoagulation: prospective evidence from observational and randomized protocols. Am J M May 15 2004;116:651-6

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