Abstract 10572: Vitamin K Supplementation Slows the Progression of Aortic Valve Calcification
Introduction: Vitamin K and vitamin K-dependent proteins play pivotal roles in preventing ectopic calcification. It has been suggested that patients on long-term treatment with vitamin K antagonists show an increased progression of aortic valve calcifications. We therefore aimed to investigate whether daily vitamin K supplementation slows the progression of aortic valve calcification in patients with aortic valve disease (AVD).
Methods: 58 patients (mean age 69 ± 10 years) with echocardiographically proven AVD were prospectively included in this randomized, placebo-controlled trial. 29 patients received a treatment with 2mg phylloquinone/d (vitamin K 1) for 12 months, and 29 age-matched individuals received placebo. At baseline as well as after 12-months follow-up, all patients received an echocardiography and underwent a non-enhanced dual-source computed tomography (Definition, Siemens, Forchheim, Germany) for quantification of aortic valve calcification (AVC) severity using the Agatston AVC score.
Results: At baseline, there were no significant differences in aortic valve calcification severity between the treatment group (Agatston score 764 ± 626) and the placebo group (Agatston score 897 ± 880, p=0.50). At 12 months follow-up, there were no significant differences in hemodynamic AVD progression between both groups as assessed by echocardiography. However, patients with Vitamin K supplementation showed a significantly lower increase of Agatston aortic valve calcification scores (149 ± 204) compared to the placebo group (306 ± 332, p=0.043). Multivariate analysis including age, gender, diabetes, hypertension, glomerular filtration rate, LDL-cholesterol, baseline Agatston AVC score, and vitamin K supplementation revealed that only Vitamin K supplementation treatment was significantly associated with the percentual increase of aortic valve calcification within 12 months (p=0.031).
Conclusions: Vitamin K 1 supplementation slows the progression of aortic valve calcification in patients with AVD compared to placebo. This preliminary finding provides the rationale for further intervention trials aiming at decreasing aortic valve disease progression by vitamin K supplementation.
- © 2013 by American Heart Association, Inc.