Eureka! Institutional Repository

INTRODUCTION:Patients with increased risk of thrombosis due to arrhythmias, atrial fibrillation, thromboembolic event or mitral stenosis, are subjected to anticoagulant treatment with Vitamin K antagonists (coumarin derivatives, SINTROM). During treatment duration, reduced consumption of foods rich in Vitamin K is advised (namely green leafy vegetables), known as SINTROM diet, often leading patients to increased consumption of processed carbohydrates and, therefore, high glycemic index died, exacerbating the disease. PURPOSE:To study the link between anticoagulant treatment, specifically acenocoumarol or SINTROM and nutrition. METHODS:Towards this end, two studies were designed. First a quantitative research was conducted, with a constructed online questionnaire for a rough estimation of SINTROM usage frequency and the change of eating habits in a part of the Greek population. Subsequently a case study was conducted to evaluate the aimed nutritional interference, which is marked by increased consumption of vegetables and the subsequent reduction of the glycemic index. In the first study, a random group of volunteers was gathered (50 men, 553 women) aged 15 to 92. The volunteers were recruited after online promotion and replied online to specific questions regarding gender, age, academic level, certain anthropometric data (weight, height), being on SINTROM or not, and any nutrition changes. Google Forms software was used as platform to create a special questionnaire with protective access password and unique study identifier. The answers are taken to a “Cloud” database, were they are automatically classified in Ecxel custom formulas. Data analysis was conducted with SPSS 24.0. In the second study the case of a woman aged 55 was analyzed in detail. She had medical record of thrombosis, obesity, high blood pressure and hypothyroidism. Her nutritional record was taken as well, recall of a typical 24-hour period and anthropometric measurements. Subsequently, a diet plan rich in Vitamin K and with low glycemic index was designed. Additionally, weekly INR measurements were planned and daily meal records were kept. Finally, information was given related to the patient's condition, informative leaflets regarding the content of vitamin K in certain foods and general nutritional recommendations, to understand and adopt the specific diet plan. RESULTS: Study 1.Individuals on SINTROM (4.8%, 13men and 18women) have established changes in nutrition, mainly regarding green leafy vegetables, bread and and pasta (4%) and are overweight and obese at a rate of 75.01% compared to the equivalent percentage of individuals that are not on SINTROM (37.9%). Study 2.The patient demonstrated significant body weight loss , 10,8% of her body weight(11.3 kg) and also significant visceral fat loss (20,5%) in the first 10 weeks of the intervention. The average weekly Vitamin K intake ranged in the high estimated levels (150-200 mcg) maintaining the INR values stable within desired levels (2.5-3.5), contrary to the many INR fluctuations (increased thrombosis risk) on a SINTROM diet two years prior to the intervention. CONCLUSIONS:The recommendation of a diet high in Vitamin K to patients who receive anticoagulant treatment (SINTROM) can be not only feasible, but also beneficial , removing the coexisting risk factors of the etiopathogenesis of the disease.