Key result
Long-term warfarin use in patients with mechanical valve replacement was associated with a marked reduction in lumbar spine bone mineral density and T-score compared to controls.
Why the study?
Does long-term warfarin therapy reduce bone mineral density in patients with rheumatic valvular heart disease and mechanical valve replacement?
Case-Control (n=173)
Does long-term warfarin therapy reduce bone mineral density in patients with rheumatic valvular heart disease and mechanical valve replacement?
Long-term warfarin use in patients with mechanical valve replacement is associated with significantly reduced lumbar spine bone mineral density, suggesting a need for screening and prophylactic calcium/vitamin D supplementation.
Answers are grounded in this paper and cite their sources.
May support BMD monitoring in long-term warfarin users with mechanical valves; leaves open need for prospective trials before changing practice.
AIM: Vitamin K is an essential factor for carboxylation of bone matrix protein. Low vitamin K may be associated with reduced bone mineral density (BMD). The issue of whether long-term sodium warfarin therapy as oral anticoagulant that antagonizes vitamin K, results in decreased bone density, is controversial. Our purpose in this study was to assess the effects of warfarin on BMD. METHODS: We performed a case control study survey of bone density in 70 patients with rheumatic valvular heart disease 'mechanical valve replacement' on long-term warfarin compared with 103 randomly selected matched controls. RESULTS: There was a marked reduction in BMD (g/cm(2)) and T-score of lumbar spine between patients and controls (P = 0.048, 0.005). Duration of warfarin use was the only risk factor of significant importance respectively on spinal T-score (P < 0.03). CONCLUSIONS: Screening of patients on long-term warfarin for reduced bone density should be considered. We strongly suggest the prophylactic use of calcium-vitamin D supplements for these patients.
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Rezaieyazdi et al. (2009) conducted a case-control in Rheumatic valvular heart disease with mechanical valve replacement (n=173). Long-term warfarin vs. Matched controls was evaluated on Bone mineral density (g/cm2) and T-score of lumbar spine (p=0.048, 0.005). Long-term warfarin use in patients with mechanical valve replacement was associated with a marked reduction in lumbar spine bone mineral density and T-score compared to controls.
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