{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T18:53:24Z","timestamp":1793300004473,"version":"4.5.0"},"reference-count":33,"publisher":"American Medical Association (AMA)","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Cardiol"],"published-print":{"date-parts":[[2026,8,1]]},"abstract":"\n Importance<\/jats:title>\n Vitamin K supplementation can reduce progression of vascular calcification in patients with diabetes or end-stage kidney disease. Presently, it is unknown whether vitamin K is also beneficial in patients with symptomatic atherosclerotic coronary artery disease (CAD).<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To evaluate whether supplementation with the vitamin K homologue menaquinone-7 (MK-7) for a period of 2 years attenuates the progression of coronary artery calcification (CAC) compared with placebo.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This randomized placebo-controlled clinical trial including symptomatic patients with CAC score between 50 and 400 Agatston units (AU) with 2 years of follow-up (VitaK-CAC study). The study was conducted at 1 university hospital and 1 community-dwelling hospital in the Netherlands. Data were collected from January 2012 through October 2022 with a few interruptions; analyses were performed from January 2023 to April 2024.<\/jats:p>\n <\/jats:sec>\n \n Intervention<\/jats:title>\n Supplementation with either the vitamin K homologue menaquinone-7 (MK-7) in a daily dose of 360 \u00b5g or identical placebo.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n The primary outcome of the study was the evolution of the CAC score and calcium mass at 1 and 2 years of follow-up, as measured with computed tomography (CT) scanning. Additionally, CT angiography was performed. The incidence of new calcifications was a secondary outcome measure. Data were analyzed using a generalized estimation equations model, adjusted for covariates.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Altogether, 180 patients could be randomized (90 patients per group), with 85 patients receiving MK-7 (median [IQR] age, 59 [54-65] years; 36 [42%] female) and 82 receiving placebo (median [IQR] age, 61 [54-65] years; 34 [42%] female). Baseline characteristics were comparable for the 2 groups. Plasma levels of MK-7 rose significantly in the active treatment group (median [IQR], 0.50 [0.32-0.77] \u00b5g\/L to 6.56 [2.04-10.35] \u00b5g\/L;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001). In the placebo group, CAC scores increased from a median (IQR) of 145 (99-217) AU to 173 (119-297) AU after the first year and to 214 (148-344) AU after the second. In the active treatment group, these values were 135 (89-226), 150 (110-254) and 184 (122-298) AU, respectively. The difference between the groups was significant (\n P<\/jats:italic>\n \u2009=\u2009.02), even after adjustment for covariates. A similar result was seen for calcium mass. The increase in CAC score correlated with the number of noncalcified plaques that became partially calcified during the study (\n R<\/jats:italic>\n 2<\/jats:sup>\n \u2009=\u20090.17;\n P<\/jats:italic>\n \u2009=\u2009.04). No significant adverse effects were observed.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n The findings of this study suggest that supplementation with MK-7 for 2 years may slow calcification in noncalcified plaques of patients with symptomatic CAD. The clinical significance of this finding in terms of plaque stability remains to be determined.<\/jats:p>\n <\/jats:sec>\n \n Trial Registration<\/jats:title>\n \n ClinicalTrials.gov Identifier:\n NCT01002157<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamacardio.2026.1279","type":"journal-article","created":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T15:30:24Z","timestamp":1781105424000},"page":"719","source":"Crossref","is-referenced-by-count":10,"title":["Two Years of Menaquinone-7 Supplementation and Coronary Artery Calcification"],"prefix":"10.1001","volume":"11","author":[{"given":"Liv M.","family":"Vossen","sequence":"first","affiliation":[{"name":"Department of Medicine, Maastricht University Medical Center, Maastricht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter W.","family":"de Leeuw","sequence":"additional","affiliation":[{"name":"Department of Medicine, Maastricht University Medical Center, Maastricht, the Netherlands"},{"name":"Cardiovascular Research Institute Maastricht (CARIM), Maastricht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leon J.","family":"Schurgers","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Institute Maastricht (CARIM), Maastricht, the Netherlands"},{"name":"Department of Biochemistry, University of Maastricht, Maastricht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Heuts","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Maastricht University Medical Center, Maastricht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bouke P.","family":"Adriaans","sequence":"additional","affiliation":[{"name":"Department of Cardiology, VieCuri MC, Venlo, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"de Haan","sequence":"additional","affiliation":[{"name":"Department of Medicine, Maastricht University Medical Center, Maastricht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernard J.","family":"van Varik","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Wilhelmina Ziekenhuis Assen, Assen, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abraham A.","family":"Kroon","sequence":"additional","affiliation":[{"name":"Department of Medicine, Maastricht University Medical Center, Maastricht, the Netherlands"},{"name":"Cardiovascular Research Institute Maastricht (CARIM), Maastricht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"issue":"12","key":"hoi260027r1","doi-asserted-by":"publisher","first-page":"938","DOI":"10.1136\/heartjnl-2018-313955","article-title":"Vitamin K status, supplementation and vascular disease: a systematic review 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