Consequence of Patient Substitution of Nattokinase for Warfarin After Aortic Valve Replacement with a Mechanical Prosthesis

• Published in: Proceedings - Baylor University. Medical Center Vol. 28; no. 1; pp. 81 - 82
• Main Authors: Elahi, Maqsood M., Choi, Charles H., Konda, Subbareddy, Shake, Jay G.
• Format: Journal Article
• Language: English
• Published: United States Taylor & Francis 01-01-2015; Taylor & Francis Group LLC; Taylor & Francis Ltd; Baylor Health Care System
• Subjects: Care and treatment; Case Studies; Complications and side effects; Dosage and administration; Health aspects; Heart valve diseases; Heart valve replacement; Warfarin; United States
• ISSN: 0899-8280; 1525-3252
• DOI: 10.1080/08998280.2015.11929198

This report describes a patient's self-substitution of nattokinase for the vitamin K antagonist warfarin after aortic valve replacement with a mechanical prosthesis. Nattokinase is an enzyme derived from a popular fermented soybean preparation in Japan (natto), which has fibrinolytic properties and is gaining popularity in nontraditional health journals and nonmedical health websites as an over-the-counter thrombolytic. After nearly a year of use of nattokinase without warfarin, the patient developed thrombus on the mechanical valve and underwent successful repeat valve replacement. We believe this is the first documented case of nattokinase being used as a substitute for warfarin after valve replacement, and we strongly discourage its use for this purpose.