Prevention of vasculopathy by vitamin K supplementation: can we turn fiction into fact?
With the discovery that vitamin K-dependent matrix Gla-protein (MGP) is a strong and modifiable factor in the prevention of arterial calcification, vitamin K was put forward as novel treatment option in cardiovascular disease. The vasculoprotective properties of vitamin K are in part based on the ability to improve gamma-glutamylcarboxylation of MGP, which is a prerequisite for MGP as a calcification inhibitor. Data from experimental animal models reveal that high intake of vitamin K can prevent and even reverse vascular calcifications. In addition, clinical data demonstrate that prescription of vitamin K antagonists for long-term oral anticoagulant therapy accelerates vascular calcification. However, controlled data from randomized prospective vitamin K interventional trials are lacking, thereby weakening a general recommendation for supplementation. The present article summarizes our current knowledge on the association between vitamin K and cardiovascular health. Additionally, we focus on an outlook on important ongoing prospective vitamin K intervention studies. These studies address the issues whether vitamin K substitution helps modifying relevant cardiovascular surrogates such as vascular calcification and whether non-vitamin K oral anticoagulants provide an alternative to support cardiovascular health benefits. So research about cardiovascular protection by vitamin K is an evolving field in which we expect a boost of novel and relevant evidence shortly.
Department of Cardiology, University Hospital of the RWTH Aachen, Germany. Electronic address: VMBrandenburg@aol.com.
Vincent M
VM
Brandenburg
Department of Biochemistry, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands.
Leon J
LJ
Schurgers
Department of Nephrology, University Hospital of the RWTH Aachen, Germany.
Nadine
N
Kaesler
Department of Cardiology, University Hospital of the RWTH Aachen, Germany.
Katrin
K
Püsche
Department of Biochemistry, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands.
Rick H
RH
van Gorp
Department of Physiology and Vascular Investigation, Medical School and University Hospital of Angers, Angers, France.
Georges
G
Leftheriotis
Department of Radiology, University Hospital of the RWTH Aachen, Germany.
Sebastian
S
Reinartz
Department of Cardiology, University Hospital of the RWTH Aachen, Germany.
Ralf
R
Koos
Department of Nephrology, University Hospital of the RWTH Aachen, Germany.
Thilo
T
Krüger
D000818:Animals; D000925:Anticoagulants / Q000009:adverse effects; D050197:Atherosclerosis / Q000453:epidemiology / Q000378:metabolism / Q000517:prevention & control; D019587:Dietary Supplements; D006801:Humans; D015675:Osteocalcin / Q000378:metabolism; D065840:Protective Factors; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome; D061205:Vascular Calcification / Q000453:epidemiology / Q000378:metabolism / Q000517:prevention & control; D014652:Vascular Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000378:metabolism / Q000517:prevention & control*; D014812:Vitamin K / Q000627:therapeutic use*; D014813:Vitamin K Deficiency / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology
D000925:Anticoagulants; D015675:Osteocalcin; D014812:Vitamin K
Anticoagulation; Arteriosclerosis; Matrix-gla protein; Vascular calcification; Vitamin K