Warning: file_get_contents(https://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=26593943
&cmd=llinks): Failed to open stream: HTTP request failed! HTTP/1.1 429 Too Many Requests
in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 215
New Insights into the Pros and Cons of the Clinical Use of Vitamin K Antagonists
(VKAs) Versus Direct Oral Anticoagulants (DOACs)
#MMPMID26593943
van Gorp RH
; Schurgers LJ
Nutrients
2015[Nov]; 7
(11
): 9538-57
PMID26593943
show ga
Vitamin K-antagonists (VKA) are the most widely used anticoagulant drugs to treat
patients at risk of arterial and venous thrombosis for the past 50 years. Due to
unfavorable pharmacokinetics VKA have a small therapeutic window, require
frequent monitoring, and are susceptible to drug and nutritional interactions.
Additionally, the effect of VKA is not limited to coagulation, but affects all
vitamin K-dependent proteins. As a consequence, VKA have detrimental side effects
by enhancing medial and intimal calcification. These limitations stimulated the
development of alternative anticoagulant drugs, resulting in direct oral
anticoagulant (DOAC) drugs, which specifically target coagulation factor Xa and
thrombin. DOACs also display non-hemostatic vascular effects via
protease-activated receptors (PARs). As atherosclerosis is characterized by a
hypercoagulable state indicating the involvement of activated coagulation factors
in the genesis of atherosclerosis, anticoagulation could have beneficial effects
on atherosclerosis. Additionally, accumulating evidence demonstrates vascular
benefit from high vitamin K intake. This review gives an update on oral
anticoagulant treatment on the vasculature with a special focus on calcification
and vitamin K interaction.