Should We Recommend Vitamin K2 Supplement to Prevent Coronary Artery Calcification for Patients Receiving Statins and/or Warfarin?

Autor: Zhang AJ; School of Medicine, Baylor College of Medicine, Houston, TX, USA., Ballantyne CM; The Section of Cardiology, The Department of Medicine, Baylor College of Medicine, 7200 Cambridge Street, MS BCM620, Houston, TX, 77030, USA., Birnbaum Y; The Section of Cardiology, The Department of Medicine, Baylor College of Medicine, 7200 Cambridge Street, MS BCM620, Houston, TX, 77030, USA. ybirnbau@bcm.edu.
Jazyk: angličtina
Zdroj: Cardiovascular drugs and therapy [Cardiovasc Drugs Ther] 2024 Dec 13. Date of Electronic Publication: 2024 Dec 13.
DOI: 10.1007/s10557-024-07661-2
Abstrakt: Several reports suggest that in animal models, as well as in the clinical setting, long-term warfarin use increases coronary artery calcifications. The same has been reported for statins prescribed for patients at risk or with established atherosclerosis. Coronary calcifications are considered a risk marker for further cardiovascular events. However, numerous clinical trials have established that statins reduce the risk for cardiovascular events. Warfarin also has been shown to reduce the risk of cardiovascular events, including re-infarction. It has been suggested that the increase in coronary calcification can be viewed as a marker of stabilization of the coronary plaque in such patients. Warfarin inhibits the activation of Vitamin K epoxide reductase complex 1 (VKORC1), which blocks the regeneration of reduced vitamin K1 and K2. Vitamin K1 is predominantly localized to the liver, serving to carboxylate clotting factors. Vitamin K2 travels through systemic circulation, with significant and wide-ranging effects. Several studies using animal models of atherosclerosis have shown that vitamin K2 supplement can attenuate the progression of atherosclerosis, as well as coronary calcification. Clinical studies supporting this effect in patients are lacking. Yet, there is an increase in the use of over-the-counter vitamin K2 supplements, and several manuscripts recommended its use in patients receiving long-term warfarin to attenuate coronary calcification. However, it is unclear if this occurs in patients with atherosclerosis receiving warfarin or statins and if attenuating coronary calcification has beneficial or detrimental effects on cardiovascular outcomes.
Competing Interests: Declarations. Ethics approval: Not relevant for a review. Consent to participate: Not relevant for a review. Consent to publish: Not relevant for a review. Competing Interests: Allan Jean Zhang: No relevant financial or non-financial interests to disclose. Christie M. Ballantyne: Grant/research support (through his institution) from Abbott Diagnostic, Akcea, Amgen, Arrowhead, Ionis, Merck, New Amsterdam, Novartis, Novo Nordisk, and Roche Diagnostic for contracted research and consulting fees from 89Bio, Abbott Diagnostics, Amarin, Amgen, Arrowhead, Astra Zeneca, Denka Seiken, Esperion, Genentech, Illumina, Ionis, Eli Lilly, Merck, New Amsterdam, Novartis, Novo Nordisk, and Roche Diagnostic as a consultant. Yochai Birnbaum: No relevant financial or non-financial interests to disclose.
(© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
Externí odkaz: