Gut Microbiota and the Quality of Oral Anticoagulation in Vitamin K Antagonists Users: A Review of Potential Implications

Camelo-Castillo, Anny, Rivera-Caravaca, Jose Miguel ORCID: 0000-0003-0492-6241, Orenes-Pinero, Esteban, Ramirez-Macias, Inmaculada, Roldan, Vanessa, Lip, Gregory YH ORCID: 0000-0002-7566-1626 and Marin, Francisco (2021) Gut Microbiota and the Quality of Oral Anticoagulation in Vitamin K Antagonists Users: A Review of Potential Implications. JOURNAL OF CLINICAL MEDICINE, 10 (4). 715-.

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Official URL: http://dx.doi.org/10.3390/jcm10040715

Abstract

The efficacy and safety of vitamin K antagonists (VKAs) as oral anticoagulants (OACs) depend on the quality of anticoagulation control, as reflected by the mean time in therapeutic range (TTR). Several factors may be involved in poor TTR such as comorbidities, high inter-individual variability, interacting drugs, and non-adherence. Recent studies suggest that gut microbiota (GM) plays an important role in the pathogenesis of cardiovascular diseases, but the effect of the GM on anticoagulation control with VKAs is unknown. In the present review article, we propose different mechanisms by which the GM could have an impact on the quality of anticoagulation control in patients taking VKA therapy. We suggest that the potential effects of GM may be mediated first, by an indirect effect of metabolites produced by GM in the availability of VKAs drugs; second, by an effect of vitamin K-producing bacteria; and finally, by the structural modification of the molecules of VKAs. Future research will help confirm these hypotheses and may suggest profiles of bacterial signatures or microbial metabolites, to be used as biomarkers to predict the quality of anticoagulation. This could lead to the design of intervention strategies modulating gut microbiota, for example, by using probiotics.

Item Type:	Article
Uncontrolled Keywords:	oral anticoagulants, gut microbiota, microbial metabolites, vitamin k, trimethylamine n-oxide
Divisions:	Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Faculty Management Office Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences
Depositing User:	Symplectic Admin
Date Deposited:	30 Jun 2021 10:16
Last Modified:	18 Jan 2023 21:37
DOI:	10.3390/jcm10040715
Open Access URL:	https://doi.org/10.3390/jcm10040715
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3128250