Oral anticoagulant treatment: friend or foe in cardiovascular disease?
Calcification is a common complication in cardiovascular disease and may affect both arteries and heart valves. Matrix gamma-carboxyglutamic acid (Gla) protein (MGP) is a potent inhibitor of vascular calcification, the activity of which is regulated by vitamin K. In animal models, vitamin K antagonists (oral anticoagulants [OACs]) were shown to induce arterial calcification. To investigate whether long-term OAC treatment may induce calcification in humans also, we have measured the grade of aortic valve calcification in patients with and without preoperative OAC treatment. OAC-treated subjects were matched with nontreated ones for age, sex, and disease. Calcifications in patients receiving preoperative OAC treatment were significantly (2-fold) larger than in nontreated patients. These observations suggest that OACs, which are widely used for antithrombotic therapy, may induce cardiovascular calcifications as an adverse side effect.
Schurgers
Leon J
LJ
Department of Biochemistry, Cardiovascular Research Institute, University Maastricht, PO Box 616, 6200 MD Maastricht, The Netherlands. l.schurgers@bioch.unimaas.nl.
Aebert
Hermann
H
Vermeer
Cees
C
Bültmann
Burkhard
B
Janzen
Jan
J
D000284:Administration, Oral; D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects*; D001021:Aortic Valve / Q000473:pathology; D002114:Calcinosis / Q000139:chemically induced / Q000453:epidemiology / Q000473:pathology; D002318:Cardiovascular Diseases / Q000139:chemically induced* / Q000453:epidemiology / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013927:Thrombosis / Q000517:prevention & control; D014812:Vitamin K / Q000037:antagonists & inhibitors*
D000925:Anticoagulants; D014812:Vitamin K