Excessive consumption of vitamin K1-rich foods may antagonise the action of warfarin. Eating a large amount of brussels sprouts precipitated hospital admission for a patient who was on anticoagulation therapy for a left ventricular assist device. Doctors should counsel all patients in whom maintenance of anticoagulation is crucial against overconsumption of such foods.
A man in Scotland with chronic heart failure and severe left ventricular systolic dysfunction caused by coronary artery disease received a HeartMate II (Thoratec) left ventricular assist device (LVAD) as a bridge to transplantation. In line with standard practice, he was anticoagulated with warfarin. The target international normalised ratio (INR) was 2.0 (reference interval, 1.8–2.2). Stable anticoagulation was achieved with a daily dose of 7 mg.
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- 1. US Department of Agriculture, Agricultural Research Service. USDA national nutrient database for standard reference, release 25. 2012. http://www.ars.usda.gov/ba/bhnrc/ndl (accessed Nov 2012).
- 2. Ovesen L, Lyduch S, Idorn ML. The effect of a diet rich in brussels sprouts on warfarin pharmacokinetics. Eur J Clin Pharmacol 1988; 34: 521-523.
- 3. Kidd LR, Hanumantharaya DH. Sprouting a warfarin interaction. BMJ 2010; 341: c2621.
- 4. Kempin SJ. Warfarin resistance caused by broccoli. N Engl J Med 1983; 308: 1229-1230.
- 5. Walker FB. Myocardial infarction after diet-induced warfarin resistance. Arch Intern Med 1984; 144: 2089-2090.
- 6. Suvarna R, Pirmohamed M, Henderson L. Possible interaction between warfarin and cranberry juice. BMJ 2003; 327: 1454.
Stephen Pettit and Roy Gardner do not like brussels sprouts.