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113 - Dietary restriction and homocysteine levels during the oral anticoagulant treatment

Autor(s): E. Cancellieri, A. Ripari, L. Cresci, M. De Bernardis, A. Montanelli

Issue: RIMeL - IJLaM, Vol. 3, N. 2, 2007 (MAF Servizi srl ed.)

Page(s): 113-116

Background. It’s known that a diet with large amounts of vegetables of vitamin K rich is effective in increasing the percentage of the level of the therapeutic range in patients with poorly controlled anticoagulation. This kind of food is a very important source not only of vitamin K but also of folates, which are involved in homocysteine (Hcy) metabolism. It is known that the lower the folate level, the higher the Hcy concentration, so we suspected that patients under chronic anticoagulant treatment and dietary restriction of green vegetables could show hyperhomocysteinemia. The aim of this study was to evaluate plasmatic Hcy levels in patients treated with oral anticoagulation therapy and a diet lacking in vitamin K. Methods. Hcy levels of 70 patients receiving oral anticoagulation treatment for at least 1 year and a restricted diet (group I), were compared with those of 70 untreated subjects of a similar age (group II). Hcy levels were also evaluated in a group of 12 patients before and during anticoagulant treatment. Results. We did not find a significant difference of plasmatic Hcy levels between the two groups of patients nor was any significant difference shown before and during the anticoagulant treatment period. Conclusions. Our data suggest that a vitamin K-restricted diet applied to oral anticoagulated patients will not induce an increase in Hcy levels. Patients with documented hyperomocysteinemia undergoing oral anticoagulant treatment certainly need to be treated with B -vitamins; for all the others, the proposition of this treatment is still under discussion. Key words: Oral anticoagulant treatment, Homocysteine, Diet.

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