Key result
Each year of vitamin K antagonist treatment was associated with a 3.2% increased odds of being in a higher coronary artery calcification category (OR 1.032), whereas NOAC treatment showed no such association.
Why the study?
VKA interferes with matrix-Gla protein, an inhibitor of arterial calcification, prompting investigation into whether VKA treatment is associated with coronary artery calcification extent in individuals without prior CVD.
Does vitamin K antagonist treatment increase coronary artery calcification compared to NOACs in patients with no prior cardiovascular disease?
Observational (n=17,254)
Yes
Does vitamin K antagonist treatment increase coronary artery calcification compared to NOACs in patients with no prior cardiovascular disease?
Odds Ratio: 1.032 (95% CI 1.009–1.057)
p-value: p=0.007
Vitamin K antagonist use, but not NOAC use, is associated with increased coronary artery calcification in patients without prior cardiovascular disease.
May link long-term VKA use to greater coronary calcification; leaves open clinical impact and need for prospective confirmation.
BACKGROUND AND AIMS: Vitamin K antagonists (VKA) remain the most frequently prescribed oral anticoagulants worldwide despite the introduction of non-vitamin K antagonist oral anticoagulants (NOAC). VKA interfere with the regeneration of Vitamin K1 and K2, essential to the activation of coagulation factors and activation of matrix-Gla protein, a strong inhibitor of arterial calcifications. This study aimed to clarify whether VKA treatment was associated with the extent of coronary artery calcification (CAC) in a population with no prior cardiovascular disease (CVD). METHODS: We collected data on cardiovascular risk factors and CAC scores from cardiac CT scans performed as part of clinical examinations (n = 9,672) or research studies (n = 14,166) in the period 2007-2017. Data on use of anticoagulation were obtained from the Danish National Health Service Prescription Database. The association between duration of anticoagulation and categorized CAC score (0, 1-99, 100-399, ≥400) was investigated by ordered logistic regression adjusting for covariates. RESULTS: The final study population consisted of 17,254 participants with no prior CVD, of whom 1,748 and 1,144 had been treated with VKA or NOAC, respectively. A longer duration of VKA treatment was associated with higher CAC categories. For each year of VKA treatment, the odds of being in a higher CAC category increased (odds ratio (OR) = 1.032, 95%CI 1.009-1.057). In contrast, NOAC treatment duration was not associated with CAC category (OR = 1.002, 95%CI 0.935-1.074). There was no significant interaction between VKA treatment duration and age on CAC category. CONCLUSIONS: Adjusted for cardiovascular risk factors, VKA treatment-contrary to NOAC-was associated to higher CAC category.
No takes yet. Share an insight, caveat, or question.
Hasific et al. (2020) conducted an observational in No prior cardiovascular disease (n=17,254). Vitamin K antagonists (VKA) vs. Non-vitamin K antagonist oral anticoagulants (NOAC) or no anticoagulation was evaluated on Categorized coronary artery calcification (CAC) score (0, 1-99, 100-399, ≥400) (OR 1.032, 95% CI 1.009-1.057, p=0.007). Each year of vitamin K antagonist treatment was associated with a 3.2% increased odds of being in a higher coronary artery calcification category (OR 1.032), whereas NOAC treatment showed no such association.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: