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

• Published in: Nutrition journal Vol. 15; no. 1; p. 53
• Main Authors: Ikari, Yuji, Torii, Sho, Shioi, Atsushi, Okano, Toshio
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 12.05.2016; BioMed Central
• Subjects: Abnormalities; Aged; Ankle Brachial Index; Body Mass Index; Calcification; Cardiomyopathies - prevention & control; Coronary arteries; Coronary Vessels - drug effects; Coronary Vessels - metabolism; Dietary Supplements; Endpoint Determination; Female; Health aspects; Hemostatics - administration & dosage; Humans; Male; Middle Aged; Nutrition; Pilot Projects; Prospective Studies; Pulse Wave Analysis; Quinone; 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; Coronary artery calcification; Pulse wave velocity; Vitamin K
• ISSN: 1475-2891; 1475-2891
• DOI: 10.1186/s12937-016-0175-8

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). 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. 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. 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. This study was registered as UMIN 000002760.