Abstract
Warfarin, kumarin türevi bir antikoagülan olup K vitamini antagonistidir. K vitamini kemik metabolizmasında önemli bir rol oynar. Uzun süreli warfarin kullanımının, kot ve vertebra kırığı riskini arttırdığı bildirilmiştir. Burada, kronik warfarin kullanımına bağlı Th6 vertebra kompresyon kırığı ile karşılaşılan 60 yaşındaki bir erkek olguyu sunuyoruz. Çeşitli ilaçların uzun süreli kullanımlarında kemik üzerine etkileri tartışıldı. Birçok sistemik ek hastalığı özellikle kardiyovasküler hastalığı olan ve antikoagülan ilaçlar kullanan hastalar vertebra kırık riski açısından dikkatlice değerlendirilmelidirler.
References
- 1. Woo C, Chang LL, Ewing SK, Bauer DC. Single-point assessment of warfarin use and risk of osteoporosis in elderly men. J Am Geriatr Soc. 2008;56:1171-6.
- 2. Sugiyama T, Takaki T, Sakanaka K, Sadamaru H, Mori K, Kato Y, Taguchi T, Saito T. Warfarin-induced impairment of cortical bone material quality and compensatory adaptation of cortical bone structure to mechanical stimuli. J Endocrinol. 2007;194:213-22.
- 3. Caraballo PJ, Heit JA, Atkinson EJ, Silverstein MD, O'Fallon WM, Castro MR, Melton LJ. Long-term use of oral anticoagulants and the risk of fracture. Arch Intern Med. 1999;159:1750-6.
- 4. Pilon D, Castilloux AM, Dorais M, LeLorier J. Oral anticoagulants and the risk of osteoporotic fractures among elderly. Pharmacoepidemiol Drug Saf. 2004;13:289-94.
- 5. Gage BF, Birman-Deych E, Radford MJ, Nilasena DS, Binder EF. Risk of osteoporotic fracture in elderly patients taking warfarin: results from the National Registry of Atrial Fibrillation 2. Arch Intern Med. 2006;166:241-6.
- 6. Binkley N, Krueger D, Engelke J, Suttie J. Vitamin K deficiency from long-term warfarin anticoagulation does not alter skeletal status in male rhesus monkeys. J Bone Miner Res. 2007;22:695-700.
- 7. Avgeri M, Papadopoulou A, Platokouki H, Douros K, Rammos S, Nicolaidou P, Aronis S. Assessment of bone mineral density and markers of bone turnover in children under long-term oral anticoagulant therapy. J Pediatr Hematol Oncol. 2008;30:592-7.
- 8. Pearson DA. Bone Health and Osteoporosis: The role of vitamin K and potential antagonism by anticoagulants. Nutr Clin Pract. 2007;22:517-44.
- 9. Walsh JS, Newman C, Eastell R. Heart drugs that affect bone. Trends Endocrinol Metab. 2012;23:163-8.
Abstract
Warfarin, a coumarin derivative anticoagulant, is a vitamin K antagonist. Vitamin K plays an important role in bone metabolism. Long-term warfarin use has been reported to increase the fracture risk of rib and vertebra. Here, we present a case of a 60-year-old man, who encountered a compression fracture of Th6 vertebra due to chronic warfarin use. Several drugs, which affect bones at long-term use, are discussed in this study. Patients both with many systemic comorbidities-cardiovascular diseases in particular and in the habit of using anticoagulant drugs should carefully be assessed for the fracture risk of vertebra.
References
- 1. Woo C, Chang LL, Ewing SK, Bauer DC. Single-point assessment of warfarin use and risk of osteoporosis in elderly men. J Am Geriatr Soc. 2008;56:1171-6.
- 2. Sugiyama T, Takaki T, Sakanaka K, Sadamaru H, Mori K, Kato Y, Taguchi T, Saito T. Warfarin-induced impairment of cortical bone material quality and compensatory adaptation of cortical bone structure to mechanical stimuli. J Endocrinol. 2007;194:213-22.
- 3. Caraballo PJ, Heit JA, Atkinson EJ, Silverstein MD, O'Fallon WM, Castro MR, Melton LJ. Long-term use of oral anticoagulants and the risk of fracture. Arch Intern Med. 1999;159:1750-6.
- 4. Pilon D, Castilloux AM, Dorais M, LeLorier J. Oral anticoagulants and the risk of osteoporotic fractures among elderly. Pharmacoepidemiol Drug Saf. 2004;13:289-94.
- 5. Gage BF, Birman-Deych E, Radford MJ, Nilasena DS, Binder EF. Risk of osteoporotic fracture in elderly patients taking warfarin: results from the National Registry of Atrial Fibrillation 2. Arch Intern Med. 2006;166:241-6.
- 6. Binkley N, Krueger D, Engelke J, Suttie J. Vitamin K deficiency from long-term warfarin anticoagulation does not alter skeletal status in male rhesus monkeys. J Bone Miner Res. 2007;22:695-700.
- 7. Avgeri M, Papadopoulou A, Platokouki H, Douros K, Rammos S, Nicolaidou P, Aronis S. Assessment of bone mineral density and markers of bone turnover in children under long-term oral anticoagulant therapy. J Pediatr Hematol Oncol. 2008;30:592-7.
- 8. Pearson DA. Bone Health and Osteoporosis: The role of vitamin K and potential antagonism by anticoagulants. Nutr Clin Pract. 2007;22:517-44.
- 9. Walsh JS, Newman C, Eastell R. Heart drugs that affect bone. Trends Endocrinol Metab. 2012;23:163-8.
Details
| Primary Language | English |
|---|---|
| Subjects | Internal Diseases |
| Journal Section | Case Report |
| Authors | |
| Publication Date | August 1, 2018 |
| Submission Date | January 24, 2018 |
| Published in Issue | Year 2018 Volume: 5 Issue: 2 |
