title: Relation of oral anticoagulation to cardiac valvular and coronary calcium assessed by multislice spiral computed tomography.
abstract: Vitamin K antagonists, known as oral anticoagulants, affect the synthesis and function of the matrix Gla protein, which is a potent inhibitor of tissue calcification. We performed multislice spiral computed tomography in 86 patients (53 men, mean age 71 +/- 8 years) with calcific aortic valve disease to quantitate the amount of calcification in the aortic valve and coronary arteries. Patients with long-term oral anticoagulation therapy (mean duration 88 +/- 113 months; n = 23) were compared with those without anticoagulation (n = 63). No differences were found in the demographic, clinical, or echocardiographic characteristics between the 2 study groups. Patients on oral anticoagulant therapy had increased coronary calcium (coronary Agatston score 1,561 +/- 1,141 vs 738 +/- 978, respectively; p = 0.024) and valvular calcium (valvular Agatston score 2,410 +/- 1,759 vs 1,070 +/- 1,085, respectively; p = 0.002) compared with patients without anticoagulation treatment. The results of our study have demonstrated that oral anticoagulation may be associated with increased valvular and coronary calcium in patients with aortic valve disease, presumably due to decreased activation of the matrix Gla protein.
authors.affiliation: Department of Cardiology, University Hospital Aachen, University of Technology Aachen, Aachen, Germany. rkoos@ukaachen.de
authors.forename: Ralf
authors.initials: R
authors.lastname: Koos
authors.forename: Andreas Horst
authors.initials: AH
authors.lastname: Mahnken
authors.forename: Georg
authors.initials: G
authors.lastname: Mühlenbruch
authors.forename: Vincent
authors.initials: V
authors.lastname: Brandenburg
authors.forename: Benjamin
authors.initials: B
authors.lastname: Pflueger
authors.forename: Joachim Ernst
authors.initials: JE
authors.lastname: Wildberger
authors.forename: Harald Peter
authors.initials: HP
authors.lastname: Kühl
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects*; D001021:Aortic Valve / Q000187:drug effects*; D002114:Calcinosis / Q000000981:diagnostic imaging*; D003324:Coronary Artery Disease / Q000139:chemically induced / Q000000981:diagnostic imaging*; D005260:Female; D006349:Heart Valve Diseases / Q000139:chemically induced / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D036542:Tomography, Spiral Computed; D016896:Treatment Outcome; D014859:Warfarin / Q000009:adverse effects
chemical_list: D000925:Anticoagulants; D014859:Warfarin