THE IL-6 DEPENDENT EFFECT OF ORAL WARFARIN IN HEART VALVE REPLACEMENT PATIENTS BY MEASURING INTERACTING CLINICAL AND DEMOGRAPHIC VARIABLES

Heart Valves Replacement And Antithrombotic Therapies

Abstract

Objective: To examine an inflammatory effect of warfarin and comparing with IL-6 levels along with different demographic and clinical variables.
Study Design: Qusai experimental study.
Place and Duration of Study: Center of Research in Experimental and Applied Medicine (CREAM), Army Medical College/National University of Sciences and Technology, Islamabad from Oct 2013 to Oct 2015.
Material and Methods: The study design was Quasi Experimental study. Samples were collected by Nonprobability convenience sampling. Total 76 patients were included according to warfarin dose response in warfarin therapy patients, i.e. 32(42%) were taking <5mg/day, 37(49%) had been put on dose 5-10mg/day and 7(09%) were taking>10mg/day of warfarin dose. Patient’s demographic and clinical variables were noted i.e. age, gender, BMI, duration of therapy, INR history, hepatic, gastrointestinal and diabetic complications. Human IL-6 ELISA assay was performed.
Results: The statistically significant difference was found between age groups (in years) and different levels of warfarin dose (p=0.046) along with IL-6 production. There is a negative correlation between warfarin dose and age group i.e. as age increases, the dose of warfarin decreases. Among the inter and intra-patient variability age and serum IL-6 levels were found to be statistically significant with warfarin dose response. BMI and warfarin dose were found to be weak positively correlated.
Conclusion: A marked immunomodulatory response of warfarin was noted by measuring IL-6 levels. IL-6 levels retained a significant association with warfarin dose.