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Should we still be utilizing warfarin in the type 2 diabetic patient?
Author(s) -
Bell David S. H.,
Goncalves Edison
Publication year - 2018
Publication title -
diabetes, obesity and metabolism
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.445
H-Index - 128
eISSN - 1463-1326
pISSN - 1462-8902
DOI - 10.1111/dom.13371
Subject(s) - medicine , atrial fibrillation , warfarin , cardiology , type 2 diabetes , thrombin , diabetes mellitus , anticoagulant , endocrinology , platelet
The frequency of non‐valvular atrial fibrillation is increased by 40% in type 2 diabetic individuals and the thromboembolic risk associated with atrial fibrillation is increased by 79% compared with the non‐diabetic individual with atrial fibrillation. Warfarin, the traditional anticoagulant used to prevent thromboembolism, is non‐specific and affects several proteins outside the coagulation system. Decreasing the levels of matrix Gla protein entails an increase in coronary and renal artery calcification, which has the potential to increase cardiovascular events and accelerate decline in renal function. The direct‐acting oral anticoagulants are specific, directly inhibiting either thrombin or factor Xa, and have been shown to be safer and more efficacious in studies of the type 2 diabetic patient.