Impact of menaquinone-4 supplementation on coronary artery calcification and arterial stiffness: an open label single arm study

Nutr J. 2016 May 12;15(1):53. doi: 10.1186/s12937-016-0175-8.

Abstract

Background: Dietary intake of vitamin K has been reported to reduce coronary artery calcification (CAC) and cardiovascular events. However, it is unknown whether supplemental menaquinone (MK)-4 can reduce CAC or arterial stiffness. To study the effect of MK-4 supplementation on CAC and brachial ankle pulse wave velocity (baPWV).

Methods: This study is a single arm design to take 45 mg/day MK-4 daily as a therapeutic drug for 1 year. Primary endpoint was CAC score determined using 64-slice multislice CT (Siemens), and the secondary endpoint was baPWV measured before and 1 year after MK-4 therapy.

Results: A total of 26 patients were enrolled. The average age was 69 ± 8 years and 65 % were female. Plasma levels of phylloquinone (PK), MK-7, and MK4 were 1.94 ± 1.38 ng/ml, 14.2 ± 11.9 ng/ml and 0.4 ± 2.0 ng/ml, respectively, suggesting that MK-7 was the dominant vitamin K in the studied population. Baseline CAC and baPWV were 513 ± 773 and 1834 ± 289 cm/s, respectively. At 1 year following MK-4 supplementation, the values were 588 ± 872 (+14 %) and 1821 ± 378 cm/s (-0.7 %), respectively. In patients with high PIVKA-2, -18 % annual reduction of baPWV was observed.

Conclusion: Despite high dose MK-4 supplementation, CAC increased +14 % annually, but baPWV did not change (-0.7 %). The benefits of MK-4 supplementation were only observed in patients with vitamin K insufficiencies correlated with high PIVKA-2 baseline levels, reducing baPWV but not CAC.

Trial registration: This study was registered as UMIN 000002760.

Keywords: Coronary artery calcification; Pulse wave velocity; Vitamin K.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Ankle Brachial Index
  • Body Mass Index
  • Cardiomyopathies / prevention & control*
  • Coronary Vessels / drug effects*
  • Coronary Vessels / metabolism
  • Dietary Supplements*
  • Endpoint Determination
  • Female
  • Hemostatics / administration & dosage*
  • Humans
  • Male
  • Middle Aged
  • Pilot Projects
  • Prospective Studies
  • Pulse Wave Analysis
  • Risk Factors
  • Vascular Stiffness / drug effects*
  • Vitamin K 1 / administration & dosage
  • Vitamin K 1 / blood
  • Vitamin K 2 / administration & dosage
  • Vitamin K 2 / analogs & derivatives*
  • Vitamin K 2 / blood

Substances

  • Hemostatics
  • Vitamin K 2
  • menatetrenone
  • Vitamin K 1
  • vitamin MK 7

Associated data

  • JPRN/UMIN 000002760