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A Chinese patient with cardiogenic stroke and warfarin resistance: a case report.
BMC Neurol
February 2025
Department of Neurology, Yongchuan Hospital of Chongqing Medical University, 439 Xuanhua Road, Yongchuan District, Chongqing, China.
Background: Warfarin is the most commonly used oral anticoagulant drug in clinical practice due to its effective anticoagulant effect and low cost. Warfarin plays a crucial role in the anticoagulant treatment of patients with thrombotic diseases such as atrial fibrillation, heart valve replacement, and deep vein thrombosis. In general, low-dose warfarin can effectively achieve the optimal international normalized ratio (INR) for patients requiring anticoagulation therapy.
View Article and Find Full Text PDFAscorbic acid-induced warfarin resistance after breast cancer surgery: a case report and literature review.
Front Pharmacol
April 2024
Department of Thyroid and Breast Surgery, Chongming Hospital Affiliated to Shanghai University of Medicine and Health Sciences, Shanghai, China.
Article Synopsis
- Warfarin, an anticoagulant, requires dosage adjustments based on INR levels, and ascorbic acid may reduce its effectiveness, as shown in limited studies.
- A 63-year-old woman experienced warfarin resistance after taking ascorbic acid for anemia linked to breast cancer surgery; her INR stayed low even when her warfarin dosage was increased.
- Once ascorbic acid was discontinued, her INR quickly rose to target levels, suggesting a direct link between the vitamin C intake and the reduced warfarin effectiveness; patients taking both should closely monitor their INR and stop ascorbic acid if resistance occurs.
A Case of Unexplained Warfarin Resistance: A Case Report and Literature Review.
J Tehran Heart Cent
October 2023
Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
Adjusting the exact warfarin dose has always been challenging since it has a narrow therapeutic window. Numerous factors, including poor drug compliance, drug-drug interactions, and malabsorption syndromes, affect the warfarin plasma concentration, leading to oversensitivity or resistance to warfarin. Patients who need more than 15 mg/d of warfarin for maintained anticoagulant effects are considered warfarin resistant.
View Article and Find Full Text PDFOne Rare Warfarin Resistance Case and Possible Mechanism Exploration.
Pharmgenomics Pers Med
June 2023
Pharmacy Department, China-Japan Friendship Hospital, Beijing, People's Republic of China.
One 59-year-old female patient with deep venous thrombosis (DVT) and pulmonary embolism (PE) was treated with 6 mg warfarin once daily as an anticoagulant. Before taking warfarin, her international normalized ratio (INR) was 0.98.
View Article and Find Full Text PDFMissense VKOR mutants exhibit severe warfarin resistance but lack VKCFD via shifting to an aberrantly reduced state.
Blood Adv
May 2023
Department of Biochemistry and Molecular Biophysics, Washington University School of Medicine, St. Louis, MO.
Missense vitamin K epoxide reductase (VKOR) mutations in patients cause resistance to warfarin treatment but not abnormal bleeding due to defective VKOR activity. The underlying mechanism of these phenotypes remains unknown. Here we show that the redox state of these mutants is essential to their activity and warfarin resistance.
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