Concerns about clinical efficacy and safety of warfarin in diabetic patients with atrial fibrillation View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2019-12

AUTHORS

Sho-ichi Yamagishi

ABSTRACT

Atrial fibrillation (AF) is one of the most common arrhythmias in elderly people. The risk of thromboembolic stroke is increased in AF patients, especially those with diabetes. Anticoagulant therapy, such as warfarin and non-vitamin K oral anticoagulants (NOACs), is recommended for diabetic patients with AF. However, recent guidelines do not preferentially recommend NOACs over warfarin for diabetic patients. Variability of glycemic control in diabetic patients could affect the pharmacokinetics and anticoagulant activity of warfarin, therefore, the risk-benefit balance of warfarin is prone to be compromised in diabetic patients with AF. Furthermore, since warfarin inhibits the vitamin K-dependent gamma-glutamyl carboxylation of proteins, including osteocalcin and matrix Gla protein, use of warfarin may increase the risk of osteoporotic bone fracture and vascular calcification, both of which are the leading causes of morbidity that diminish the quality of life in diabetic patients. Even though the cost of NOACs is high, NOACs may be preferable to warfarin for the treatment of diabetic patients with AF. More... »

PAGES

12

Journal

TITLE

Cardiovascular Diabetology

ISSUE

1

VOLUME

18

Author Affiliations

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/s12933-019-0818-0

DOI

http://dx.doi.org/10.1186/s12933-019-0818-0

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1111751144

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/30691466


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