Latest research on Warfarin

Warfarin is an anticoagulant drug normally used to prevent blood clot formation as well as migration. Although originally marketed as a pesticide (d-Con, Rodex, among others), Warfarin has since become the most frequently prescribed oral anticoagulant in North America. Warfarin has several properties that should be noted when used medicinally, including its ability to cross the placental barrier during pregnancy which can result in fetal bleeding, spontaneous abortion, preterm birth, stillbirth, and neonatal death. Additional adverse effects such as necrosis, purple toe syndrome, osteoporosis, valve and artery calcification, and drug interactions have also been documented with warfarin use. Warfarin does not actually affect blood viscosity, rather, it inhibits vitamin-k dependent synthesis of biologically active forms of various clotting factors in addition to several regulatory factors.

Latest findings

Examples of such efforts include a freely available web-based platform that helps estimating a patient’s therapeutic Warfarin dose based on PGx variants and other clinical parameters, such as body weight and co-medication (www.WarfarinDosing.org). [source, 2016]
Factors contributing to VC include age, comorbidity (diabetes, hypertension, metabolic syndrome, dyslipidemia), dialysis vintage, medications (Calcium, Vitamin D, Coumadin), and uremia-related mineral bone disorder (serum Calcium [Ca], phosphorus [P], Parathyroid hormone [PTH]) 11-15. [source, 2016]
It is superior to Warfarin for prevention of stroke or systemic emboli without increasing bleeding in patients with non-valvular AF. [source, 2016]
Warfarin was initiated and the follow-up was uneventful. [source, 2016]
In contrast, although there is a consensus that pre-procedural uninterrupted Warfarin is safe and effective for preventing procedure-related thromboembolism,13 termination of NOACs for 24–48 hours before the procedure has been recommended by the European Heart Rhythm Association (EHRA) practical guide. [source, 2016]
Therefore, we hypothesized that NOACs are non-inferior to continuous Warfarin in the peri-procedural period of AF catheter ablation, despite the transient blanking period. [source, 2016]
The purpose of our study was to compare the use of NOACs and uninterrupted Warfarin in the peri-procedural period for AF catheter ablation in terms of safety, efficacy, and intra-procedural heparin requirement. [source, 2016]
Among 632 consecutive patients in the Yonsei AF ablation cohort between September 2012 and October 2014, 141 patients taking peri-procedural NOACs (72% men; 58±11 years old; 71% with paroxysmal AF) were initially compared to 491 patients taking uninterrupted Warfarin before AF ablation. [source, 2016]
We then conducted propensity score matching between the continuous Warfarin group and the NOAC group. [source, 2016]
A total of 141 patients in the NOAC group and 281 age-, sex-, AF type-, and history of stroke-matched patients in the Warfarin group were compared. [source, 2016]