Vitamin K antagonist anticoagulants and diet: a review of reviews Section: Reviews How to quote Jorge Araujo P. Anticoagulantes antagonistas de la vitamina K y alimentación: una revisión de revisiones. Rev. iberoam. Educ. investi. Enferm. 2024; 14(1):e17. doi: https://doi.org/10.56104/Aladafe.2024.14.1021000442 AuthorsPedro Jorge Araujo Position Doctor por la Universidad de Las Palmas de Gran Canaria. Centro de Salud de Cueva Torres. Gerencia de Atención Primaria de Gran Canaria. Servicio Canario de la Salud. Las Palmas (España) Contact email: pedroja25@hotmail.com Abstract Objective: locate, organize and synthesize information from systematic reviews that deal with nutrition, feeding, diet and VKAs published to date.Methodology: umbrella review conducted in February 2024 consulting 7 databases: Cochrane Library, PubMed/MEDLINE, ScienceDirect (Elsevier), Web of Science, SCOPUS, EMBASE and Google Scholar (Academic).Results: a total of 1.089 records were identified. After eliminating duplicates and screening the documents according to the established selection criteria, a total of 2 systematic reviews were finally included. More studies are needed. The findings found so far on the effect of dietary intake of vitamin K on the coagulation response are contradictory. Some studies found a negative correlation between this and changes in INR, while others suggested that a minimal amount of vitamin K is required to maintain adequate anticoagulation. On the other hand, the role of daily vitamin K supplementation in patients receiving VKA treatment remains to be established. This may be associated with a clinically relevant increase in time in therapeutic range in patients with unstable anticoagulation control.Conclusions: In the absence of more systematic reviews that provide more data on the subject, the most important advice that should be given to patients receiving oral anticoagulants that are vitamin K antagonists is to follow a healthy diet with adequate dietary intake of vitamin K and constant. Versión en Español Título: Anticoagulantes antagonistas de la vitamina K y alimentación: una revisión de revisiones Artículo completo no disponible en este idioma / Full article is not available in this language Bibliography 1. Shafik Y, Morsy TA. Mini-overview of vitamin K. J Egypt Soc Parasitol 2020; 50(3):522-34. doi: https://doi.org/10.21608/jesp.2020.1310812. Kampouraki E, Kamali F. Dietary implications for patients receiving long-term oral anticoagulation therapy for treatment and prevention of thromboembolic disease. Expert Rev Clin Pharmacol. 2017; 10(8):789-797. doi: https://doi.org/10.1080/17512433.2017.13456223. Parveen S, Pandey R, Sharma N, Kant Thakur S, Sharma V, Mishra A. Cardiovascular Health And Vitamin K Status: Evidence From Observational And Clinical Studie. J Pharm Negat Results. 2022; 13(10):3698-702. doi: https://doi.org/10.47750/pnr.2022.13.S10.4474. Palmer CR, Blekkenhorst LC, Lewis JR, Ward NC, Schultz CJ, Hodgson JM, et al. Quantifying dietary vitamin K and its link to cardiovascular health: a narrative review. Food Funct. 2020; 11(4):2826-37. doi: https://doi.org/10.1039/c9fo02321f5. Popa DS, Bigman G, Rusu ME. The Role of Vitamin K in Humans: Implication in Aging and Age-Associated Diseases. Antioxidants (Basel). 2021; 10(4):566. doi: https://doi.org/10.3390/antiox100405666. Simes DC, Viegas CSB, Araújo N, Marreiros C. Vitamin K as a Diet Supplement with Impact in Human Health: Current Evidence in Age-Related Diseases. Nutrients. 2020; 12(1):138. doi: https://doi.org/10.3390/nu120101387. Di Minno A, Frigerio B, Spadarella G, Ravani A, Sansaro D, Amato M, et al. Old and new oral anticoagulants: Food, herbal medicines and drug interactions. Blood Rev. 2017; 31(4):193-203. doi: https://doi.org/10.1016/j.blre.2017.02.0018. Pengo V, Denas G. Optimizing quality care for the oral vitamin K antagonists (VKAs). Hematology Am Soc Hematol Educ Program. 2018; 2018(1):332-8. doi: https://doi.org/10.1182/asheducation-2018.1.3329. Roldán V, Marín F. Optimizing Vitamin K Antagonist Treatment in Patients with Mechanical Heart Valve Prosthesis. Thromb Haemost. 2020; 118(5):806-7. doi: https://doi.org/10.1055/s-0038-164173710. Riva N, Ageno W. Pros and cons of vitamin K antagonists and non-vitamin K antagonist oral anticoagulants. Semin Thromb Hemost. 2015; 41(2):178-87. doi: https://doi.org/10.1055/s-0035-154423111. Holmes MV, Hunt BJ, Shearer MJ. The role of dietary vitamin K in the management of oral vitamin K antagonists. Blood Rev. 2012; 26(1):1-14. doi: https://doi.org/10.1016/j.blre.2011.07.00212. Eichinger S. Reversing vitamin K antagonists: making the old new again. Hematology Am Soc Hematol Educ Program. 2016; 2016(1):605-11. doi: https://doi.org/10.1182/asheducation-2016.1.60513. Linkins LA. Bleeding risks associated with vitamin K antagonists. Blood Rev. 2013; 27(3):111-8. doi: https://doi.org/10.1016/j.blre.2013.02.00414. Phillips KW, Ansell J. Outpatient management of oral vitamin K antagonist therapy: defining and measuring high-quality management. Expert Rev Cardiovasc Ther. 2008; 6(1):57-70. doi: https://doi.org/10.1586/14779072.6.1.5715. Kluch M, Górska-Ciebiada M, ?okie? K. The importance of diet in the prevention of adverse reactions to vitamin K-dependent anticoagulants (The importance of diet in the prevention of adverse reactions to vitamin K-dependent anticoagulants). Pol Merkur Lekarski [internet]. 2018 [citado 8 nov 2024]; 45(265):5-10. Polish. Disponible en: https://medpress.com.pl/pubmed.php?article=2655.16. Harshman SG, Saltzman E, Booth SL. Vitamin K: dietary intake and requirements in different clinical conditions. Curr Opin Clin Nutr Metab Care 2014 Nov; 17(6):531-8. doi: https://doi.org/10.1097/MCO.000000000000011217. Witt DM. Approaches to optimal dosing of vitamin K antagonists. Semin Thromb Hemost. 2012; 38(7):667-72. doi: https://doi.org/10.1055/s-0032-132471318. Marongiu F, Finazzi G, Pengo V, Poli D, Testa S, Tripodi A. Management of special conditions in patients on vitamin K antagonists. Intern Emerg Med. 2012; 7(5):407-13. doi: https://doi.org/10.1007/s11739-011-0627-219. Akl EA, Muti P, Schünemann HJ. Anticoagulation in patients with cancer: an overview of reviews. Pol Arch Med Wewn [internet]. 2008 Apr [citado 8 nov 2024]; 118(4):183-93. Disponible en: https://www.mp.pl/paim/issue/article/356/.20. Khouja C, Brunton G, Richardson M, Stokes G, Blanchard L, Burchett H, et al. Oral anticoagulants: a systematic overview of reviews on efficacy and safety, genotyping, self-monitoring, and stakeholder experiences. Syst Rev. 2022 Oct 28; 11(1):232. doi: https://doi.org/10.1186/s13643-022-02098-w21. Brunton G, Richardson M, Stokes G, Blanchard L, Burchett H, Khatwa M, et al. The effective, safe and appropriate use of anticoagulation medicines: A systematic overview of reviews [internet]. London: EPPI-Centre, Social Science Research Unit, UCL Institute of Education, University College London; 2018 [citado 8 nov 2024]. Disponible en: https://eppi.ioe.ac.uk/cms/Portals/0/PDF%20reviews%20and%20summaries/FINAL%20REPORT%20OAC%20update.pdf?ver=2018-07-30-102531-29022. Román López P, Rodríguez Arrastia MJ, Ropero Padilla C. Metodología de la investigación: de lector a divulgador. Textos docentes nº 83. Almería: Editorial Universidad de Almería; 2021.23. Cabello López JB. Lectura crítica de la evidencia clínica. Barcelona: Elsevier España; 2021.24. Cabello JB. por CASPe. Plantilla para ayudarte a entender una Revisión Sistemática. En: CASPe. Guías CASPe de Lectura Crítica de la Literatura Médica. Alicante: CASPe; 2005. Cuaderno I. p.13-17.25. Violi F, Lip GY, Pignatelli P, Pastori D. Interaction Between Dietary Vitamin K Intake and Anticoagulation by Vitamin K Antagonists: Is It Really True? A Systematic Review. Medicine (Baltimore). 2016; 95(10):e2895. doi: https://doi.org/10.1097/MD.000000000000289526. Dentali F, Crowther M, Galli M, Pomero F, Garcia D, Clark N, et al. Effect of Vitamin K Intake on the Stability of Treatment with Vitamin K Antagonists: A Systematic Review of the Literature. Semin Thromb Hemost. 2016; 42(6):671-81. doi: https://doi.org/10.1055/s-0036-158110527. Krüger T, Floege J. Vitamin K antagonists: beyond bleeding. Semin Dial. 2014; 27(1):37-41. doi: https://doi.org/10.1111/sdi.1217528. Simes DC, Viegas CSB, Araújo N, Marreiros C. Vitamin K as a Powerful Micronutrient in Aging and Age-Related Diseases: Pros and Cons from Clinical Studies. Int J Mol Sci. 2019; 20(17):4150. doi: https://doi.org/10.3390/ijms2017415029. Khatib R, Ludwikowska M, Witt DM, Ansell J, Clark NP, Holbrook A, et al. Vitamin K for reversal of excessive vitamin K antagonist anticoagulation: a systematic review and meta-analysis. Blood Adv. 2019; 3(5):789-96. doi: https://doi.org/10.1182/bloodadvances.201802516330. Schein JR, White CM, Nelson WW, Kluger J, Mearns ES, Coleman CI. Vitamin K antagonist use: evidence of the difficulty of achieving and maintaining target INR range and subsequent consequences. Thromb J. 2016; 14:14. doi: https://doi.org/10.1186/s12959-016-0088-y