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Warfarin Patients Treated with Vitamin K

Warfarin is a popular anticoagulant commonly prescribed in people with atrial fibrillation. It works by inhibiting the recycling of vitamin K, so that it's not able to activate the clotting factors that depend on it for proper functioning. However, as we now know, vitamin K is also needed for various other functions in the body, and those taking warfarin are known to be at high risk of osteoporotic fractures (and cardiovascular disease by way of arterial calcification).

Hip fractures are common in the elderly population, and many also take warfarin. Surgical treatment of these fractures within the first 48 hours decreases morbidity and mortality, but because warfarin is a blood thinner, surgery within this short time-frame is difficult--it's important that the coagulation is "normal" before surgery. Therefore, the researchers behind this study sought to determine the effect of vitamin K on hip fracture patients treated with warfarin.

In this small study, they examined the management of 21 patients with hip fractures who were being treated with warfarin at the time of admission. 10 mg (10,000 mcg) of vitamin K was given to 11 of the 21 patients. A third group (the control group), consisted of 35 hip fracture patients who were not being treated with anticoagulants.

Results showed that patients who received vitamin K took fewer days to reach target international normalized ratio (INR, a measure of blood clotting) and was ready for surgery in fewer days compared to patients who did not receive vitamin K. Further, these patients required shorter hospitalization post-surgery. 

So it looks like this is another use for vitamin K. Ironically, the fractures are many times related to the "induced deficiency" of vitamin K that warfarin causes.

While the study doesn't mention what kind of vitamin K was administered, I have to assume it was K1. This is important to note because the various forms of K available on the market have different pharmacokinetic profiles, so 10 mg of K1 would not be the same as 10 mg of MK-7 (a form of K2). Based on coagulation studies, MK-7 seems to be far more potent in coagulation than K1, so presumably far less MK-7 is needed to achieve the same results.

Source: Treatment with Vitamin K in Hip Fracture Patients Receiving Warfarin

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