Background: Coronary and aortic
artery calcifications are generally slow to develop, and their burden predicts
cardiovascular disease events. In patients with diabetes mellitus, arterial
calcification is accelerated and calcification activity can be detected using
18F-sodium fluoride positron emission tomography (18F-NaF PET).


 


Objectives: We aimed to determine
whether vitamin K1 supplementation inhibits arterial calcification activity in
individuals with diabetes mellitus.


 


Methods: This was a post hoc
analysis of the ViKCoVaC (effect of Vitamin-K1 and Colchicine on Vascular
Calcification activity in subjects with Diabetes Mellitus) double-blind
randomized controlled trial conducted in Perth, Western Australia. Individuals
with diabetes mellitus and established coronary calcification (coronary calcium
score > 10), but without clinical coronary artery disease, underwent
baseline 18F-NaF PET imaging, followed by oral vitamin K1 supplementation (10
mg/d) or placebo for 3 mo, after which 18F-NaF PET imaging was repeated. We
tested whether individuals randomly assigned to vitamin K1 supplementation had
reduced development of new 18F-NaF PET positive lesions within the coronary
arteries and aorta.


 


Results: In total, 149 individuals
completed baseline and follow-up imaging studies. Vitamin K1 supplementation
independently decreased the odds of developing new 18F-NaF PET positive lesions
in the coronary arteries (OR: 0.35; 95% CI: 0.16, 0.78; P = 0.010), aorta (OR:
0.27; 95% CI: 0.08, 0.94; P = 0.040), and in both aortic and coronary arteries
(OR: 0.28; 95% CI: 0.13, 0.63; P = 0.002).


 


Conclusions: In individuals with
diabetes mellitus, supplementation with 10 mg vitamin K1/d may prevent the
development of newly calcifying lesions within the aorta and the coronary
arteries as detected using 18F-NaF PET. Further long-term studies are needed to
test this hypothesis.This trial was registered at anzctr.org.au as
ACTRN12616000024448.