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Hypothesis – Use of anticoagulants with COPD lowers Vitamin K, which increases calcification – Nov 2017

Vitamin K deficiency: the linking pin between COPD and cardiovascular diseases?

Respir Res. 2017 Nov 13;18(1):189. doi: 10.1186/s12931-017-0673-z.
Piscaer I1, Wouters EFM2,3, Vermeer C4, Janssens W5, Franssen FME2,3, Janssen R6.
1 Department of Respiratory Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands. ianthe.piscaer at mumc.nl.
2 Department of Respiratory Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands.
3 CIRO, Center of Expertise for Chronic Organ Failure, Horn, The Netherlands.
4 R&D Group VitaK, Maastricht University, Maastricht, The Netherlands.
5 Department of Chronic Diseases, Metabolism and Ageing, Laboratory of Respiratory Disease, University of Leuven, Leuven, Belgium.
6 Department of Pulmonary Medicine, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands.


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Cardiovascular diseases are prevalent in patients with chronic obstructive pulmonary disease (COPD). Their coexistence implies that many COPD patients require anticoagulation therapy. Although more and more replaced by direct oral anticoagulants, vitamin K antagonists (VKAs) are still widely used. VKAs induce profound deficiency of vitamin K, a key activator in the coagulation pathway. It is recognized however that vitamin K is also an essential cofactor in the activation of other extrahepatic proteins, such as matrix Gla protein (MGP), a potent inhibitor of arterial calcification. No or insufficient MGP activation by the use of VKAs is associated with a rapid progression of vascular calcification, which may enhance the risk for overt cardiovascular disease. Vitamin K consumption, on the other hand, seems to have a protective effect on the mineralization of arteries.
Furthermore, vascular calcification mutually relates to elastin degradation, which is accelerated in patients with COPD associating with impaired survival. In this commentary, we hypothesize that vitamin K is a critical determinant to the rate of elastin degradation. We speculate on the potential link between poor vitamin K status and crucial mechanisms of COPD pathogenesis and raise concerns about the use of VKAs in patients with this disease. Future intervention studies are needed to explore if vitamin K supplementation is able to reduce elastin degradation and vascular calcification in COPD patients.

PMID: 29132356 PMCID: PMC5683584 DOI: 10.1186/s12931-017-0673-z

Created by admin. Last Modification: Thursday January 25, 2018 19:41:15 GMT-0000 by admin. (Version 6)

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9254 COPD CVD bar chart.jpg admin 25 Jan, 2018 70.38 Kb 526
9253 COPD CVD Vit K.pdf admin 25 Jan, 2018 747.86 Kb 825