冠状动脉钙化(CAC)的程度和进展是心肌梗死和死亡率的有力预测因子。
■本研究旨在调查补充维生素K2和D是否可以减少CAC进展。
■在一项多中心双盲随机对照试验中,共有389名参与者被随机分为补充维生素K2(720μg/天)和D(25μg/天)和安慰剂。已经报道了主要终点(主动脉瓣钙化的进展)。这项研究报告了没有缺血性心脏病的参与者的CAC进展。在基线时进行CT扫描,12和24个月。在整个组和2个亚组中评估ΔCAC和冠状动脉斑块体积。安全终点是心肌梗死的复合终点,冠状动脉血运重建,和全因死亡率。
■总共,304名参与者(男性,平均年龄71岁)。干预组和安慰剂组从基线到24个月随访的平均CAC评分均增加(Δ203vsΔ254AU,P=0.089)。在CAC评分≥400AU的患者中,通过干预,CAC进展较低(Δ288对Δ380AU,P=0.047)。斑块分析显示,非钙化斑块体积的进展没有显着差异(Δ-6对Δ46mm3,P=0.172)。接受补充剂的参与者的安全事件较少(1.9%vs6.7%,P=0.048)。
■与安慰剂相比,在2年的随访中,没有接受维生素K2和D补充的缺血性心脏病患者的平均CAC进展没有显着降低。虽然主要终点是中性的,CAC评分≥400AU和安全性终点的患者对补充的差异反应是未来研究的假设.
UNASSIGNED: Extent and progression of coronary artery calcification (CAC) are strong predictors of myocardial infarction and mortality.
UNASSIGNED: This study aims to investigate if vitamin K2 and D supplementation can reduce CAC progression.
UNASSIGNED: A total of 389 participants were randomized to supplementation with vitamin K2 (720 μg/day) and D (25 μg/day) vs placebo in a multicenter double-blinded randomized controlled trial. The primary endpoint (progression of aortic valve calcification) has been reported. This study reports CAC progression in participants with no ischemic heart disease. CT scans were performed at baseline, 12, and 24 months. ΔCAC and coronary plaque volume were evaluated in the entire group and in 2 subgroups. A safety endpoint was the composite of myocardial infarction, coronary revascularization, and all-cause mortality.
UNASSIGNED: In total, 304 participants (male, mean age 71 years) were identified. The intervention and placebo group both increased in mean CAC scores from baseline to 24-month follow-up (Δ203 vs Δ254 AU, P = 0.089). In patients with CAC scores ≥400 AU, CAC progression was lower by intervention (Δ288 vs Δ380 AU, P = 0.047). Plaque analyses showed no significant difference in progression of noncalcified plaque volume (Δ-6 vs Δ46 mm3, P = 0.172). Safety events were fewer in participants receiving supplementation (1.9% vs 6.7%, P = 0.048).
UNASSIGNED: Patients with no prior ischemic heart disease randomized to vitamin K2 and D supplementation had no significant reduction in mean CAC progression over a 2-year follow-up compared to placebo. Although the primary endpoint is neutral, differential responses to supplementation in those with CAC scores ≥400 AU and in safety endpoints are hypothesis-generating for future studies.