Effects of Different Warfarin Doses on Il-6 and Cox-2 Levels

Background: Warfarin has been widely used for a long time as an oral anticoagulant agent. Warfarin is reported to have inflammatory role as well. The dose of Warfarin plays an important role in up and down regulation of interacting cytokines such as IL-6 and COX-2 (Cyclooxygenase). Objective: To investigate the effects of varying Warfarin doses on IL-6 and COX-2. Material and Methods: Serum IL-6 and COX-2 levels were determined by ELISA. Results and Discussion: Total 107 patients who had undergone valvular heart disease and were on warfarin therapy were included in the study of which 43 (40.2%) were taking warfarin <5mg/day, 57 (53.3%) had been put on dose 5-10mg/day and 7(6.5%) were taking >10mg/day of warfarin dose. It was observed that in patients on high dose warfarin therapy increased COX-2 caused stimulation of IL-6. Low dose warfarin down regulated the production of IL-6 and thus the synthesis of COX-2. A positive correlation was observed between IL-6 and COX-2 levels. Conclusion: It was concluded that warfarin alters the inflammatory function of cells by directly influencing the IL-6 and COX-2 levels