Effect of Some Risk Factors on Over-Anticoagulation Disorders and Bleeding in Patients Receiving Anticoagulant Therapy with Overdosage of Vitamin K Antagonist

Abstract

Objective

Study on effect of risk factors on over-anticoagulation in patients taking anticoagulant drugs with VKAs (vitamin K antagonists).

Methods

Cross-sectional descriptive, prospective research. Study on 79 patients taking anticoagulant drugs with VKAs who had an INR (International Normalized Ratio) index of more than indicated anticoagulation dose with VKAs therapy.

Results

A total of 79 patients, mean age 65.65 ± 12.17 years [33:85], the elderly group is common (73.4%). Patients had hemorrhage disorders account for 22.8%. The INR index had an average value was 5.88 ± 3.0 [3.02–23.95]; The INR> 5 level group is a higher risk of bleeding than the INR ≤5 level group, it’s the statistical significance (p < 0.001). The risk factors such as drugs to treat dyslipidemia, hyperthyroid, amiodarone, beta blocker, prednisone, NSAIDs (Non-steroidal anti-inflammatory), BMI (Body Mass Index), smoke and alcohol that the risk factors of increasing of bleeding when receiving anticoagulants but it’s not statistically significant yet (OR >1, p > 0.05); These patients using coenzyme Q10 and green vegetable nutrition such as cruciferous vegetables (Brassicaceae, Asteraceae) are quite common (31.6% and 35.4%), its effect on coagulation with vitamin K and cause of the increased in risk of bleeding was statistical significantly with OR = 5.28 (CI: 1.72–16.17, p < 0.01), and OR = 2.99 (CI: 1.01–8.80, p < 0.05) respectively.

Conclusion

Most patients in over-anticoagulation were the elderly group. Patients had hemorrhage disorders account for 22.8%. The INR> 5 level group was a higher risk of bleeding than the INR ≤5 level group with statistical significance. Patients using Coenzyme Q10 and green vegetable nutrition such as cruciferous vegetables (Brassicaceae, Asteraceae) are quite common, its effect on coagulation and cause of the increased risk of bleeding complication with statistical significance.

Keywords:

• risk factors
• bleeding
• VKAs overdose
• INR

Abbreviations

VKAs, Vitamin K antagonist anticoagulants; INR, International Normalized Ratio; BMI, Body Mass Index; OR, Odds ratio; CI, Confidence interval; P, Prevalence; NSAID, Nonsteroidal anti-inflammatory drug.

Data Sharing Statement

The original contributions presented in this study are included in the article. Further inquiries can be directed to the corresponding author.

Ethical Statement

The authors confirmed that the guidelines outlined in the Declaration of Helsinki were followed. Informed consent was obtained from each participant. The study protocol was previously approved by Haiphong-Vinhbao International General Hospital’s Ethics committee for research on humans (Number of the ethical approval in research: 45a/QD-DKQTVB).

Acknowledgment

The authors are grateful to the Internal Medicine Department - Vietnam University of Traditional Medicine and Haiphong–Vinhbao General Hospital in Vietnam for their assistance and data collect.

Author Contributions

All authors contributed to data analysis, revised the manuscript, drafting or revised the article during the review process, agreed on the journal to which the manuscript will be submitted, gave final approval of the version to be published, and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

There is no funding to report.