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Whether evidence\u2010based interventions could significantly attenuate cardiovascular calcification progression remains uncertain.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">We conducted a systematic review of randomized controlled trials involving interventions, compared with placebo, another comparator, or standard of care, to attenuate cardiovascular calcification. Included clinical trials involved participants without chronic kidney disease, and the outcome was cardiovascular calcification measured using radiological methods. Quality of evidence was determined by the Cochrane risk of bias and Grading of Recommendations, Assessment, Development, and Evaluations assessment. Forty\u2010nine randomized controlled trials involving 9901 participants (median participants 104, median duration 12\u2009months) were eligible for inclusion. Trials involving aged garlic extract (n=6 studies) consistently showed attenuation of cardiovascular calcification. Trials involving 3\u2010hydroxy\u20103\u2010methylglutaryl coenzyme A reductase inhibitors (n=14), other lipid\u2010lowering agents (n=2), hormone replacement therapies (n=3), vitamin K (n=5), lifestyle measures (n=4), and omega\u20103 fatty acids (n=2) consistently showed no attenuation of cardiovascular calcification with these therapies. Trials involving antiresorptive (n=2), antihypertensive (n=2), antithrombotic (n=4), and hypoglycemic agents (n=3) showed mixed results. Singleton studies involving salsalate, folate with vitamin B6 and 12, and dalcetrapib showed no attenuation of cardiovascular calcification. Overall, Cochrane risk of bias was moderate, and the Grading of Recommendations, Assessment, Development, and Evaluations assessment for a majority of analyses was moderate certainty of evidence.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Currently, there are insufficient or conflicting data for interventions evaluated in clinical trials for mitigation of cardiovascular calcification. Therapy involving aged garlic extract appears most promising, but evaluable studies were small and of short duration.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.123.031676","type":"journal-article","created":{"date-parts":[[2023,11,28]],"date-time":"2023-11-28T11:26:04Z","timestamp":1701170764000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":12,"title":["Interventions to Attenuate Cardiovascular Calcification Progression: A Systematic Review of Randomized Clinical Trials"],"prefix":"10.1161","volume":"12","author":[{"given":"Shashank","family":"Murali","sequence":"first","affiliation":[{"name":"Department of Nephrology The Royal Melbourne Hospital Parkville Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2651-1787","authenticated-orcid":false,"given":"Edward R.","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Nephrology The Royal Melbourne Hospital Parkville Victoria Australia"},{"name":"Department of Medicine (RMH) University of Melbourne Parkville Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9348-4638","authenticated-orcid":false,"given":"Mark K.","family":"Tiong","sequence":"additional","affiliation":[{"name":"Department of Nephrology The Royal Melbourne Hospital Parkville Victoria Australia"},{"name":"Department of Medicine (RMH) University of Melbourne Parkville Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6972-8417","authenticated-orcid":false,"given":"Sven\u2010Jean","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Nephrology The Royal Melbourne Hospital Parkville Victoria Australia"},{"name":"Department of Medicine (RMH) University of Melbourne Parkville Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2853-5096","authenticated-orcid":false,"given":"Nigel D.","family":"Toussaint","sequence":"additional","affiliation":[{"name":"Department of Nephrology The Royal Melbourne Hospital Parkville Victoria Australia"},{"name":"Department of Medicine (RMH) University of Melbourne Parkville Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","first-page":"289","article-title":"Cell and molecular biology of septins","volume":"310","author":"Quaglino D","year":"2020","unstructured":"Quaglino D, Boraldi F, Fofaro FD. 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