Impact of Hypoalbuminemia on the Pharmacodynamics of Warfarin: Investigating the Role of Hybrid Soy–Whey Protein Supplementation in Anticoagulation Stability in Elderly Human Patients

Abstract

Background:
Warfarin is a widely used oral anticoagulant with a narrow therapeutic index and extensive plasma protein binding, primarily to serum albumin. Hypoalbuminemia is prevalent among elderly individuals and may contribute to anticoagulation instability and increased bleeding risk.Objective: This study evaluated the effect of hybrid cross-linked soy–whey protein supplementation on serum albumin concentration and anticoagulation stability in elderly patients with hypoalbuminemia receiving long-term warfarin therapy. Methods: A 12-month prospective randomized clinical study was conducted involving 150 elderly patients receiving chronic warfarin therapy. Participants were divided into three groups: control (low protein intake), standard protein intake, and hybrid protein supplementation. Outcomes included serum albumin concentration, INR variability, Time in Therapeutic Range (TTR), and warfarin dose adjustment frequency. Data were analyzed using descriptive statistics and comparative group analysis. Results: Hybrid soy–whey protein supplementation was associated with a greater increase in serum albumin levels compared with control groups. Patients receiving hybrid protein supplementation demonstrated improved anticoagulation stability, reflected by higher TTR values and reduced INR variability. Conclusion: Hybrid cross-linked soy–whey protein supplementation may contribute to improved serum albumin levels and modest stabilization of warfarin anticoagulation in elderly patients with hypoalbuminemia. Nutritional optimization should be considered as a supportive strategy alongside standard anticoagulation monitoring.