Low-intensity warfarin reduces thrombin generation and fibrin turnover, but not low-grade inflammation, in men at risk of myocardial infarction

Br J Haematol. 2004 Nov;127(4):448-50. doi: 10.1111/j.1365-2141.2004.05222.x.

Abstract

In the Thrombosis Prevention Trial (TPT), low-intensity warfarin reduced the risk of first coronary events only when the achieved international normalized ratio (INR) was > or =1.4. To validate the likely mechanism of action of low-intensity warfarin we measured its effects on plasma markers of thrombin generation, fibrin turnover and low-grade inflammation in TPT participants. D-dimer and prothrombin fragment F1.2 levels were lower at INRs > or =1.4 (P = 0.02 and 0.03 respectively); levels fell as INR increased (P for trend 0.04 and 0.002 respectively). C-reactive protein did not vary with INR. The efficacy of warfarin is related to reductions in thrombin generation and fibrin turnover.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anticoagulants / administration & dosage*
  • Coronary Thrombosis / blood
  • Fibrin / metabolism*
  • Fibrin Fibrinogen Degradation Products / metabolism
  • Humans
  • International Normalized Ratio
  • Male
  • Middle Aged
  • Myocardial Infarction / blood*
  • Peptide Fragments / metabolism
  • Prothrombin / metabolism
  • Risk Factors
  • Thrombin / metabolism*
  • Warfarin / administration & dosage*

Substances

  • Anticoagulants
  • Fibrin Fibrinogen Degradation Products
  • Peptide Fragments
  • fibrin fragment D
  • Warfarin
  • prothrombin fragment 2
  • Prothrombin
  • Fibrin
  • Thrombin