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Long-Term Exposure to Warfarin Associated with Aortic Valve Calcification in Haemodialysis Patients: Presented at ASN
By Maria Bishop
PHILADELPHIA, PA -- November 11, 2005 -- Long-term exposure to the vitamin K antagonist warfarin is associated with aortic valve (AV) calcification in haemodialysis patients, researchers reported here on November 10th here at the 38th Annual Meeting and Scientific Exposition of the American Society of Nephrologists (ASN).
"Use of warfarin for maintenance of access patency in haemodialysis patients should be carefully considered," noted Rachel M. Pilkey, MD, Assistant Professor, Department of Medicine, Queen's University, Kingston, Ontario, Canada.
Dr. Pilkey and colleagues observed 108 haemodialysis patients with dialysis vintage greater than 6 months. Clinical data was abstracted for all patients for up to two years prior to their echocardiograms.
The 18 case subjects had greater severity of AV calcification (P = .04) on echocardiography than did 90 matched controls.
Multiple linear regression revealed that predictors of AV calcification were age (P = .012), daily dose of elemental calcium (P = .016), and more than 18 months of warfarin (P = .043).
In a subgroup analysis, the team examined 39 subjects taking warfarin for at least 6 months to determine the relationship between length of warfarin exposure and AV calcification in general.
Nine patients had no AV calcification, 20 had mild calcification, five had moderate and five had severe calcification. AV calcification correlated with dialysis vintage (P = .06) and lifetime months of warfarin therapy (P = .004).
Multiple linear regression analysis showed that predictors of AV calcification included lifetime months of warfarin (P = .012), daily dose of calcitriol (P = .017) and daily dose of elemental calcium (P = .031).
Warfarin is a vitamin K antagonist and has been hypothesized for some time to be associated with extraosseous calcification.
[Presentation title: Lifetime Warfarin Exposure is Associated with Aortic Valve (AV) Calcification in Hemodialysis (HD) Patients. Abstract 740]
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