title: Patients using vitamin K antagonists show increased levels of coronary calcification: an observational study in low-risk atrial fibrillation patients.
abstract: OBJECTIVE
  Vitamin K antagonists (VKA) are currently the most frequently used drug to prevent ischaemic stroke in atrial fibrillation (AF) patients. However, VKA use has been associated with increased vascular calcification. The aim of this study was to investigate the contribution of VKA use to coronary artery calcification in low-risk AF patients.
  
  
  RESULTS
  A prospective coronary calcium scan was performed in 157 AF patients without significant cardiovascular disease (108 males; mean age 57 ± 9 years). A total of 71 (45%) patients were chronic VKA users. The duration of VKA treatment varied between 6 and 143 months (mean 46 months). No significant differences in clinical characteristics were found between patients on VKA treatment and non-anticoagulated patients. However, median coronary artery calcium scores differed significantly between patients without and patients with VKA treatment [0, inter-quartile range (IQR) 0-40, vs. 29, IQR 0-184; P = 0.001]. Mean coronary calcium scores increased with the duration of VKA use (no VKA: 53 ± 115, 6-60 months on VKA: 90 ± 167, and >60 months on VKA: 236 ± 278; P < 0.001). Multivariable logistic regression analysis revealed that age and VKA treatment were significantly related to increased coronary calcium score.
  
  
  CONCLUSIONS
  Patients using VKA show increased levels of coronary calcification. Age and VKA treatment were independently related to increased coronary calcium score.
authors.affiliation: Department of Cardiology, Maastricht University Medical Centre and Cardiovascular Research Institute Maastricht (CARIM), P.O. Box 5800, 6202 AZ Maastricht, The Netherlands. b.weijs@mumc.nl
authors.forename: Bob
authors.initials: B
authors.lastname: Weijs
authors.forename: Yuri
authors.initials: Y
authors.lastname: Blaauw
authors.forename: Roger J M W
authors.initials: RJ
authors.lastname: Rennenberg
authors.forename: Leon J
authors.initials: LJ
authors.lastname: Schurgers
authors.forename: Carl C M M
authors.initials: CC
authors.lastname: Timmermans
authors.forename: Laurent
authors.initials: L
authors.lastname: Pison
authors.forename: Robby
authors.initials: R
authors.lastname: Nieuwlaat
authors.forename: Leonard
authors.initials: L
authors.lastname: Hofstra
authors.forename: Abraham A
authors.initials: AA
authors.lastname: Kroon
authors.forename: Joachim
authors.initials: J
authors.lastname: Wildberger
authors.forename: Harry J G M
authors.initials: HJ
authors.lastname: Crijns
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000150:complications*; D003324:Coronary Artery Disease / Q000139:chemically induced* / Q000000981:diagnostic imaging; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D011446:Prospective Studies; D012307:Risk Factors; D020521:Stroke / Q000209:etiology / Q000517:prevention & control*; D061205:Vascular Calcification / Q000139:chemically induced* / Q000000981:diagnostic imaging; D014812:Vitamin K / Q000037:antagonists & inhibitors*
chemical_list: D014812:Vitamin K