A fixed low dose warfarin regimen reduces factor VII coagulant activity And may potentially reduce the risk of ischaemic heart disease

Increased factor VII coagulant activity has been identified as a risk factor for the development of ischaemic heart disease. Adjusted doses of warfarin (according to prothrombin times) reduce factor VII coagulant activity, but it is unknown whether a fixed low dose warfarin regimen is equally effective. Therefore, a double­blind crossover study was conducted in which 40 evaluable men aged 31-61 (mean 47.1) years with high factor VII coagulant activity randomly received warfarin I mg/day or placebo for 12 weeks. then crossed over to the alternative treatment.

Warfarin I mg/day significantly reduced factor VII coagulant activity by a mean of 11.3% \'S

baseline. however, this reduction was significant only when warfarin was administered after placebo. The prothrombin time was significantly longer, compared with baseline. during warfarin therapy in both patient groups but remained within normal limits. Warfarin was well tolerated.

Thus, ' ... the fixed dose of Img war/ari" daily might have be"eficial effects 0" this major risk factor Uactor VII coagula"t activityJ for isc/raemic /rean disease without disturba"ce of "ormal haemostasis'. Further studies are indicated. Poller L. MacCallum PK. Thomson JM. Kerns W. Reduction of factor VII coalulant activity (VIIC). a risk factor for ischaemic hean disease. by fixed dose warfarin: a double blind crossover study. British Hean Journal 63: 231·233. Apr 1990 .. .,

ISSN OJS6-2703/90/0616-0017/0s0I.00/0 C AdillrltenultiolUll Ltd 15

INPHARMA- 16 J •• 1990 _