Chronic coumarin treatment is associated with increased extracoronary arterial calcification in humans

Blood. 2010 Jun 17;115(24):5121-3. doi: 10.1182/blood-2010-01-264598. Epub 2010 Mar 30.

Abstract

Vascular calcification is a marker of increased cardiovascular risk. Vitamin K-dependent matrix Gla protein (MGP) is important in inhibiting calcification. Because MGP activation is vitamin K dependent, we performed a cross-sectional study investigating the relationship between the use of vitamin K antagonists and extracoronary vascular calcification. From the Dutch thrombosis services we selected 19 patients younger than 55 years who had no other cardiovascular risk factors and who had used coumarins for more than 10 years, and compared these to 18 matched healthy controls. MGP was measured, and a plain x-ray of the thighs was taken to assess femoral arterial calcifications. The odds ratio for calcification in patients versus controls was 8.5 (95% confidence interval [CI] 2.01-35.95). Coumarin use and MGP were associated with calcification, even after adjusting for other risk factors. We conclude that long-term use of coumarins is associated with enhanced extracoronary vascular calcification, possibly through the inhibition of MGP carboxylation.

MeSH terms

  • Adult
  • Anticoagulants / administration & dosage
  • Anticoagulants / adverse effects*
  • Calcinosis / chemically induced*
  • Calcinosis / diagnostic imaging
  • Calcinosis / epidemiology
  • Calcium-Binding Proteins / metabolism
  • Cardiovascular Diseases / chemically induced*
  • Cardiovascular Diseases / diagnostic imaging
  • Cardiovascular Diseases / epidemiology
  • Coumarins / administration & dosage
  • Coumarins / adverse effects*
  • Databases, Factual
  • Extracellular Matrix Proteins / metabolism
  • Female
  • Femoral Artery / diagnostic imaging
  • Femoral Artery / metabolism
  • Femoral Artery / pathology
  • Humans
  • Male
  • Middle Aged
  • Radiography
  • Regression Analysis
  • Risk Factors
  • Thrombosis / drug therapy*
  • Thrombosis / epidemiology

Substances

  • Anticoagulants
  • Calcium-Binding Proteins
  • Coumarins
  • Extracellular Matrix Proteins
  • matrix Gla protein
  • coumarin