caa a22 4500 378852221 CHVBK 20180305123326.0 cr unu---uuuuu 161128e20031117xx s 000 0 eng 10.1515/CCLM.2003.229 doi (NATIONALLICENCE)gruyter-10.1515/CCLM.2003.229 Hyperhomocysteinemia and B-Vitamin Status after Discontinuation of Oral Anticoagulation Therapy in Patients with a History of Venous Thromboembolism [Elektronische Daten] [Agata Sobczyńska-Malefora, Dominic J. Harrington, Savita Rangarajan, Jo-Anne Kovacs, Martin J. Shearer, Geoffrey F. Savidge] Although hyperhomocysteinemia is an established risk factor for venous thromboembolism there is no consensus for routine determination of circulating homocysteine in the UK, either at the beginning or end of oral anticoagulation therapy. The purpose of this study was to evaluate the prevalence of hyperhomocysteinemia and its relationship to folate and vitamin B12 status in subjects with venous thromboembolism 4 weeks after discontinuation of warfarin therapy. In 78 consecutively recruited patients, plasma homocysteine was significantly higher (p < 0.001) and red cell folate significantly lower (p = 0.03) than in controls. Plasma vitamin B12 was similar in both groups. Strikingly, 38.5% of patients had hyperhomocysteinemia (>15 μmol/l). Retrospective analysis revealed a significant positive association between plasma total homocysteine and duration of warfarin therapy (p < 0.001) but a negative, though non-significant (p = 0.06), trend with warfarin dose. The results do not suggest any direct interaction between warfarin and plasma homocysteine but raise the possibility of reduced intake of a common food source of folate and vitamin K. One possibility is the shortage of green-leafy vegetables since patients are often advised to limit their intake of this major source of vitamin K. On the basis of this study we suggest that homocysteine screening should be carried out at the time that patients begin warfarin therapy. Copyright © 2003 by Walter de Gruyter GmbH & Co. KG Medical equipment & techniques nationallicence Medical diagnosis nationallicence Diseases & disorders nationallicence Sobczyńska-Malefora Agata aut J. Harrington Dominic aut Rangarajan Savita aut Kovacs Jo-Anne aut Shearer Martin J. aut Savidge Geoffrey F. aut Clinical Chemistry and Laboratory Medicine Walter de Gruyter 41/11(2003-11-17), 1493-1497 1434-6621 41:11<1493 2003 41 cclm https://doi.org/10.1515/CCLM.2003.229 text/html Onlinezugriff via DOI 1 research article jats NATIONALLICENCE 856 40 https://doi.org/10.1515/CCLM.2003.229 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Sobczyńska-Malefora Agata aut NATIONALLICENCE 700 1- J. Harrington Dominic aut NATIONALLICENCE 700 1- Rangarajan Savita aut NATIONALLICENCE 700 1- Kovacs Jo-Anne aut NATIONALLICENCE 700 1- Shearer Martin J. aut NATIONALLICENCE 700 1- Savidge Geoffrey F. aut NATIONALLICENCE 773 0- Clinical Chemistry and Laboratory Medicine Walter de Gruyter 41/11(2003-11-17), 1493-1497 1434-6621 41:11<1493 2003 41 cclm CC0 http://creativecommons.org/publicdomain/zero/1.0 nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-gruyter