Key result
Warfarin is linked to valvular and vascular calcification by inhibiting vitamin K-dependent regulatory proteins.
Why the study?
Warfarin use has been associated with valvular and vascular calcification, but no specific guidelines exist to prevent or treat this side effect.
Does warfarin use cause valvular and vascular calcification?
Does warfarin use cause valvular and vascular calcification?
Warfarin use is associated with valvular and vascular calcification, highlighting a less-recognized side effect that may warrant the use of alternative anticoagulants.
Raises concern for calcification with long-term warfarin; leaves open whether alternatives reduce risk in prospective trials.
Vitamin K is required for the activity of various biologically active proteins in our body. Apart from clotting factors, vitamin K-dependent proteins include regulatory proteins like protein C, protein S, protein Z, osteocalcin, growth arrest-specific gene 6 protein, and matrix Gla protein. Glutamic acid residues in matrix Gla protein are γ-carboxylated by vitamin K-dependent γ-carboxylase, which enables it to inhibit calcification. Warfarin, being a vitamin K antagonist, inhibits this process, and has been associated with calcification in various animal and human studies. Though no specific guidelines are currently available to prevent or treat this less-recognized side effect, discontinuing warfarin and using an alternative anticoagulant seems to be a reasonable option. Newer anticoagulants such as dabigatran and rivaroxaban offer promise as future therapeutic options in such cases. Drugs including statins, alendronate, osteoprotegerin, and vitamin K are currently under study as therapies to prevent or treat warfarin-associated calcification.
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Palaniswamy et al. (2011) conducted a review in Valvular and vascular calcification. Warfarin was evaluated on Valvular and vascular calcification. Warfarin use is associated with valvular and vascular calcification due to its inhibition of vitamin K-dependent regulatory proteins such as matrix Gla protein.
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