Intervention nutritionnelle visant à stabiliser l’anticoagulothérapie à la warfarine sodique
Vitamin K intake has emerged as an important factor in influencing the stability of long-term anticoagulation therapy. Clinical trials have shown that patients receiving a vitamin K supplement (100 - 150 μg/d) present improvements in the stability of their anticoagulant therapy. Thus, a 24-week randomized controlled trial was conducted to verify whether similar beneficial effects could be achieved by increasing daily vitamin K intake through the diet. Patients randomly assigned to the intervention group attended workshops that provided dietary counsel to increase their vitamin K intake by ≥ 150 μg/day. Patients in the control group participated in distinct workshops providing general advice on a balanced diet. The stability of anticoagulation therapy was defined as the percentage of time spent in the therapeutic range (TTR ≥ 70%) during weeks 4 through 24 of the experimental period. Intention to treat analysis showed that the percentage of participants who benefited from an improvement in the stability of anticoagulation therapy was greater in the intervention group than the control group (44.4% vs 27.3% respectively; p=0.22). Per protocol analysis accentuated the difference between groups i.e. 52.2% vs 27.3% in intervention and control group respectively (p=0.088). Both analyses showed that the mean vitamin K intake calculated during weeks 6 through 24 was higher in the intervention than in the control group (p=0.001). The study tends to support the hypothesis that a high daily vitamin K intake improves the anticoagulation stability of warfarin-treated patients.
warfarine warfarin dietary vitamin K intake anticoagulant therapy anticoagulation instability