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Switching from Warfarin to rivaroxaban induces sufficiency of vitamin K and reduction of arterial stiffness in patients with atrial fibrillation

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A Correction to this article was published on 21 July 2020

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Abstract

Use of chronic vitamin K antagonist (VKA) induces a long-term deficiency of vitamin K, which may cause arterial stiffness and bone-related disease. Switching from VKA to rivaroxaban could induce rapid sufficiency of vitamin K and improvement of arterial stiffness. The K2 SUMMIT-3 study is a multicenter, open-label, prospective, and randomized design. Patients with atrial fibrillation who have been taking VKA for more than 6 months but less than 10 years were randomly assigned to two groups; those switching from VKA to rivaroxaban and those continuing with VKA medication. The primary endpoint was the percentage difference of brachial-ankle pulse wave velocity (baPWV) in 3 months. A total of 77 patients were randomly assigned to receive rivaroxaban (n = 38) or VKA (n = 39). The average age was 74 ± 9 years. The duration for which VKA was prescribed prior to randomization was 90 ± 87 months.

Abnormally high levels of Des-gamma carboxyprothrombin (PIVKA-II) or uncarboxylated osteocalcin (ucOC) indicating vitamin K insufficiency were observed in 100% or 82% of the patients at baseline but it reduced to 2% (p < 0.0001) or 55% (p = 0.01) at 3 months in the rivaroxaban group. To the contrary, theses data had no changes in the VKA group. The percentage difference in baPWV was − 1.4 ± 10.0% vs. 3.5 ± 14.7% in the rivaroxaban and the VKA groups, respectively. (p = 0.02). Switching from VKA to rivaroxaban resulted in rapid sufficiency of vitamin K and reduction of arterial stiffness in 3 months.

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Change history

  • 21 July 2020

    In the original publication of the article,one of the author’s name was published incorrectly as “Takamoto Furuki”.

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Acknowledgements

We express our gratitude to Ms. Eri Tomita for her clerical works.

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Authors and Affiliations

  1. Department of Cardiology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, 259-1193, Japan

    Yuji Ikari & Fumie Saito

  2. Tokai University Oiso Hospital, Oiso, Japan

    Takahiko Kiyooka & Shigemitsu Tanaka

  3. Ebina General Hospital, Ebina, Japan

    Masakazu Nagaoka

  4. Tokai University Tokyo Hospital, Tokyo, Japan

    Manabu Kimura

  5. Hadano South Gate Clinic, Hadano, Japan

    Takayuki Furuki

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  1. Yuji Ikari
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  2. Fumie Saito
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Correspondence to Yuji Ikari.

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The authors declare that they have no conflict of interests. This study was supported by Bayer Pharmaceuticals.

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The original version of this article is revised due to one of the co-author name was published incorrectly as “Takamoto Furuki” and corrected in this version as “Takayuki Furuki”.

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Ikari, Y., Saito, F., Kiyooka, T. et al. Switching from Warfarin to rivaroxaban induces sufficiency of vitamin K and reduction of arterial stiffness in patients with atrial fibrillation. Heart Vessels 35, 1727–1733 (2020). https://doi.org/10.1007/s00380-020-01651-8

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