Fever as a risk factor for increased response to Vitamin K antagonists

A review of the evidence and potential mechanisms

Timothy Self, Carrie S. Oliphant, Anne Reaves, Amy M. Richardson, Christopher W. Sands

Research output: Contribution to journalReview article

6 Citations (Scopus)

Abstract

Numerous factors affect the response to vitamin K antagonists (VKA) including age, dietary vitamin K, other drugs, pharmacogenetics, and disease states. In antithrombotic guidelines, fever is mentioned as a factor that may increase response to VKA. The purpose of this article is to review the available evidence regarding the effect of fever on response to VKA, and to discuss possible mechanisms of this effect. We performed a search of the English literature from 1943 to June 2014, using the key words fever AND warfarin, acenocoumarol, phenprocoumon, coumarin anticoagulants and VKA; fever AND vitamin K dependent clotting factors II, VII, IX, and X. One animal investigation and 6 studies in humans suggest fever increases response to VKA, but one study did not find a significant effect. The magnitude of this effect is variable. Possible mechanisms for the increased effect of VKA associated with fever are increased catabolism of vitamin K dependent clotting factors, decreased vitamin K intake, and inhibition of VKA metabolism. More rigorous studies are needed to confirm that fever increases response to warfarin and other VKA.

Original languageEnglish (US)
Pages (from-to)5-8
Number of pages4
JournalThrombosis Research
Volume135
Issue number1
DOIs
StatePublished - Jan 1 2015

Fingerprint

Vitamin K
Fever
Blood Coagulation Factors
Warfarin
Acenocoumarol
Phenprocoumon
Literature
Factor VII
Pharmacogenetics
Prothrombin
Anticoagulants
Guidelines

All Science Journal Classification (ASJC) codes

  • Hematology

Cite this

Fever as a risk factor for increased response to Vitamin K antagonists : A review of the evidence and potential mechanisms. / Self, Timothy; Oliphant, Carrie S.; Reaves, Anne; Richardson, Amy M.; Sands, Christopher W.

In: Thrombosis Research, Vol. 135, No. 1, 01.01.2015, p. 5-8.

Research output: Contribution to journalReview article

Self, Timothy ; Oliphant, Carrie S. ; Reaves, Anne ; Richardson, Amy M. ; Sands, Christopher W. / Fever as a risk factor for increased response to Vitamin K antagonists : A review of the evidence and potential mechanisms. In: Thrombosis Research. 2015 ; Vol. 135, No. 1. pp. 5-8.
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