Vitamin K and D supplementation may slow the progression of coronary artery calcification
Researchers from the University of Southern Denmark and Odense University Hospital have found that vitamin K2 and D3 supplementation slow the progression of coronary artery calcification in patients who already have severe atherosclerosis.
Atherosclerosis develops when substances including cholesterol and fat build up in the walls of the arteries. This makes the arteries stiffer and narrower and can restrict blood flow. Atherosclerosis can, among other things, lead to thrombosis, including in the coronary and cerebral arteries.
Researchers from SDU and Odense University Hospital have now identified a possible way of slowing the progression of coronary artery calcification: vitamin supplements.
- We investigated whether taking daily vitamin K2 and vitamin D supplements can slow the progression of coronary artery calcification. We tested this in almost 400 patients, all of whom had severe coronary artery calcification, explains Axel Diederichsen, Clinical Professor at the Department of Clinical Research, SDU and Odense University Hospital.
- Our studies show that it can.
Atherosclerosis is something doctors monitors because it is associated with an increased risk of thrombosis later in life.
Three questions for Axel Diederichsen about the study
What are you investigating in the study? We investigated whether vitamin K2 and vitamin D3 supplements can slow the progression of coronary artery calcification in patients who already have high levels of calcium in the coronary arteries.
What is the most important finding? We found that, among patients with high levels of calcium in the coronary arteries, vitamin K2 and D3 supplementation can slow the progression of further calcification over a period of 24 months.
Supplementation slowed the progression of coronary artery calcification without simultaneously increasing the amount of non-calcified atherosclerosis.
What can the results be used for? We can see that vitamin K2 and D3 supplementation slows the progression of coronary artery calcification. This could be a step towards a new way of preventing the progression of atherosclerosis.
Around 675,000 people in Denmark live with cardiovascular disease, and approximately 150,000 have atherosclerosis in the heart. As we get older, most of us develop atherosclerosis to a greater or lesser extent. Men typically begin to develop atherosclerosis from the age of 55 and women from the age of 65, most without noticing any symptoms.
A protein can slow the progression
Previous research has shown that a particular protein in the blood can inhibit the development of calcium deposits in the arteries.
- Vitamin K2 and vitamin D3 help produce and activate a protein that, in its active form, can inhibit calcification of the blood vessels. We therefore investigated whether a combination of the two vitamins can slow the progression of coronary artery calcification, explains Selma Hasific, medical doctor, PhD and postdoc at the Department of Clinical Research, SDU and Odense University Hospital.
The study involved 398 patients with severe coronary artery calcification who received either vitamin K2 and D3 or a placebo for 24 months. The researchers measured the amount of calcium in the coronary arteries before treatment began, during the study and after 24 months.
What is a coronary artery?
The coronary arteries are the blood vessels that run along the outside of the heart and supply the heart muscle with oxygen and nutrients. If a coronary artery becomes narrowed or blocked, it can cause angina or lead to thrombosis in the heart.
A step towards better prevention
A Dutch study has recently found the same trend in a group of patients with atherosclerosis.
- We now know that the progression of coronary artery calcification can be slowed, at least over the 24-month period covered by our study, explains Selma Hasific:
- We do not know whether supplementation with these vitamins can prevent thrombosis or improve long-term survival in this group of patients. This will require larger studies with longer follow-up periods.
- At present, we therefore cannot recommend that our patients take vitamin K2 and D3 supplements, says Axel Diederichsen:
- Our next goal is to conduct a larger study to determine whether vitamin K2 and D3 supplementation reduces the risk of thrombosis. If that proves to be the case, it would be a major breakthrough.
The results are therefore not in themselves a recommendation to start taking vitamin supplements. A review published in the prestigious journal JAMA in 2022 found that vitamin D has little or no effect on the risk of death, cardiovascular disease and cancer, while the evidence for vitamin K remains limited. Vitamin supplements can also have adverse effects. Further research is therefore needed.
How does atherosclerosis develop and why can it cause thrombosis?
Atherosclerosis is a slow process in which cholesterol and fat in particular, as well as connective tissue and, later, calcium, build up in the walls of the body's arteries. This creates what are known as plaques, which make the arteries thicker, stiffer and often narrower.
If a plaque ruptures, material from it can break away and contribute to the formation of a thrombus. This is why atherosclerosis can cause thrombosis, for example in the heart.
Angina occurs when the heart muscle does not receive enough oxygen for a period of time. This can happen when the arteries have become narrowed as a result of atherosclerosis.
About the study:
Method: The DANCODE study is a randomised clinical trial involving a total of 398 patients. Of these, 200 received vitamin K2 and D3 supplements, while 198 received a placebo. The amount of calcium in the coronary arteries was measured before, during and after the 24-month study period.
The patients had severe coronary artery calcification and were treated at three Danish hospitals: Odense, Svendborg and Vejle.
Funding: The study was funded by Kappa, which also produces vitamin K2. The tablets were manufactured by Orkla. Kappa and Orkla had no influence on the study, its methodology or the interpretation of the results.
Read the study: The study Vitamin K and D3 Supplementation in Patients with Severe Coronary Artery Calcification: The DANCODE Trial is published in Circulation: https://doi.org/10.1161/CIRCULATIONAHA.126.082363
Meet the researcher
Axel Diederichsen is Clinical Professor at the Research Unit of Cardiology, Department of Clinical Research and Odense University Hospital.
Meet the researcher
Selma Hasific completed her PhD project at the Department of Clinical Research and Odense University Hospital. The DANCODE was part of her PhD project.