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Rev Rhum Engl Ed. 1997 Apr;64(4):249-54.

Bone mineral density in patients given oral vitamin K antagonists.

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  • 1Rheumatology Department, La Timone Teaching Hospital, Marseille, France.

Abstract

BACKGROUND:

Divergent results have been obtained in studies of bone mineral density in patients under oral vitamin K antagonists.

OBJECTIVE:

To gather prospective data on bone mineral density and bone metabolism in 70 aortic valve replacement patients.

STUDY DESIGN:

49 patients who had been under oral vitamin K antagonists for at least one year after implantation of a mechanical aortic valve were compared with 21 recipients of a tissue aortic valve that did not require anticoagulant therapy. The following investigations were done in all patients: (1) dual-energy X-ray absorptiometry measurement of bone mineral density at the lumbar spine and femoral neck; (2) roentgenograms of the spine and pelvis; (3) serum assays of calcium, phosphate, creatinine, alkaline phosphatase, osteocalcin, 25-OH-vitamin D3, and parathyroid hormone.

RESULTS:

The two groups were comparable regarding age and sex ratio. No differences were found in lumbar or femoral neck bone mineral density even after adjustment for age and sex. A trend toward an increase in bone mineral density at both sites with increasing duration of vitamin K antagonist therapy was demonstrated. The only bone turnover marker difference between the two groups was a significantly lower serum osteocalcin level in the group under vitamin K antagonist therapy (P < 0.0001).

CONCLUSIONS:

Long-term vitamin K antagonist therapy does not affect bone mineral density at the lumbar spine or femoral neck and also fails to modify bone turnover markers, with the exception of osteocalcin.

PMID:
9178397
[PubMed - indexed for MEDLINE]
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