Ezetimibe enhances and stabilizes anticoagulant effect of warfarin

Ezetimibe reduces plasma levels of low-density lipoprotein cholesterol by inhibiting Niemann–Pick C1-like protein 1 (NPC1L1). A recent study demonstrated that NPC1L1 plays an important role in absorption of fat-soluble vitamins including vitamin K. We evaluated whether the add-on treatment of ezetim...

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Bibliographic Details
Published in:Heart and vessels 2017, Vol.32 (1), p.47-54
Main Authors: Hashikata, Takehiro, Yamaoka-Tojo, Minako, Kakizaki, Ryota, Nemoto, Teruyoshi, Fujiyoshi, Kazuhiro, Namba, Sayaka, Kitasato, Lisa, Hashimoto, Takuya, Ishii, Shunsuke, Kameda, Ryo, Shimohama, Takao, Tojo, Taiki, Ako, Junya
Format: Article
Language:English
Subjects:
Aged
Anticholesteremic Agents - administration & dosage
Anticholesteremic Agents - adverse effects
Anticoagulants
Anticoagulants - therapeutic use
Biomedical Engineering and Bioengineering
Blood Coagulation
Cardiac Surgery
Cardiology
Cholesterol, LDL - blood
Drug Therapy, Combination
Dyslipidemias - drug therapy
Ezetimibe - administration & dosage
Ezetimibe - adverse effects
Female
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use
International Normalized Ratio
Japan
Linear Models
Low density lipoprotein
Male
Medicine
Medicine & Public Health
Middle Aged
Original Article
Plasma
Proteins
Prothrombin Time
Retrospective Studies
Treatment Outcome
Vascular Surgery
Vitamins
Warfarin - therapeutic use
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Summary:Ezetimibe reduces plasma levels of low-density lipoprotein cholesterol by inhibiting Niemann–Pick C1-like protein 1 (NPC1L1). A recent study demonstrated that NPC1L1 plays an important role in absorption of fat-soluble vitamins including vitamin K. We evaluated whether the add-on treatment of ezetimibe affects anticoagulation in patients taking warfarin. Between October 2007 and March 2015, the administration of ezetimibe was started to a total of 101 outpatients who were already on oral anticoagulation with warfarin. We retrospectively analyzed blood lipid levels, prothrombin time international normalized ratio (PT-INR) and time in therapeutic INR range (TTR). Seventy-one patients (70 %) showed increase in PT-INR after ezetimibe treatment (1.96 ± 0.45 to 2.20 ± 0.61, p  
ISSN:0910-8327
1615-2573
DOI:10.1007/s00380-016-0832-z