title: The Use of Fish Oil with Warfarin Does Not Significantly Affect either the International Normalised Ratio or Incidence of Adverse Events in Patients with Atrial Fibrillation and Deep Vein Thrombosis: A Retrospective Study.
abstract: BACKGROUND
  Warfarin is a leading anticoagulant in the management of atrial fibrillation (AF) and deep vein thrombosis (DVT). Drug interactions influence the safety of warfarin use and while extensive literature exists regarding the effect on warfarin control and bleeding incidence with many medicines, there is little evidence on the influence of complementary medicines. The aim of this study was to assess the influence of fish and krill oil supplementation on warfarin control and bleeding incidence in AF and DVT patients.
  
  
  METHODS
  A retrospective analysis was conducted utilising patient information from a large private pathology clinic. AF and DVT patients receiving long-term warfarin therapy (>30 days) at the clinic and taking fish and krill oil supplements were eligible for study inclusion.
  
  
  RESULTS
  Of the 2081 patients assessed, a total of 573 warfarin users met the inclusion criteria with 145 patients in the fish and krill oil group (supplement group) and 428 patients in the control group. Overall, it was found that fish and krill oils did not significantly alter warfarin time in therapeutic range (TTR) or bleeding incidence, even when compared by gender.
  
  
  CONCLUSIONS
  Omega-3 supplementation with fish and krill oil does not significantly affect long-term warfarin control and bleeding and thromboembolic events when consumed concurrently in patients managed at an anticoagulation clinic.
authors.affiliation: School of Pharmacy Griffith University, Gold Coast, Queensland 4222, Australia. rebecca.pryce@griffithuni.edu.au.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Pryce
authors.affiliation: School of Pharmacy Griffith University, Gold Coast, Queensland 4222, Australia. n.bernaitis@griffith.edu.au.|Menzies Health Institute Queenslands, Griffith University, Gold Coast, Queensland 4222, Australia. n.bernaitis@griffith.edu.au.
authors.forename: Nijole
authors.initials: N
authors.lastname: Bernaitis
authors.affiliation: School of Pharmacy Griffith University, Gold Coast, Queensland 4222, Australia. a.davey@griffith.edu.au.|Menzies Health Institute Queenslands, Griffith University, Gold Coast, Queensland 4222, Australia. a.davey@griffith.edu.au.
authors.forename: Andrew K
authors.initials: AK
authors.lastname: Davey
authors.affiliation: Royal College of Pathologists of Australasia Quality Assurance Programs, St Leonards, New South Wales 2065, Australia. tony.badrick@rcpaqap.com.au.
authors.forename: Tony
authors.initials: T
authors.lastname: Badrick
authors.affiliation: School of Pharmacy Griffith University, Gold Coast, Queensland 4222, Australia. s.dukie@griffith.edu.au.|Menzies Health Institute Queenslands, Griffith University, Gold Coast, Queensland 4222, Australia. s.dukie@griffith.edu.au.
authors.forename: Shailendra
authors.initials: S
authors.lastname: Anoopkumar-Dukie
keywords: atrial fibrillation; bleeding; deep vein thrombosis; fish oil; krill oil; time in therapeutic range; warfarin