Circulation:维生素K2和维生素D对主动脉瓣钙化的疗效

2022-04-26 MedSci原创 MedSci原创

在AVC评分为>300 AU的老年男性中,2年的MK-7 +维生素D补充治疗并不能改变AVC的进展。

甲基萘醌-7 (MK-7),也被称为维生素K2,是一种参与抑制动脉钙化蛋白羧化的辅助因子,已被认为可以降低主动脉狭窄患者主动脉瓣钙化(AVC)的进展程度。

近日,心血管领域权威杂志Circulation上发表了一篇研究文章,在这项随机、双盲、多中心试验中,来自心脏计算机断层扫描AVC评分为>300AU的社区的男性随机接受每日720 μg MK-7片+25 μg维生素D或匹配的安慰剂治疗24个月。

该研究的主要观察指标为AVC评分的变化。该研究选定的次要结局指标包括超声心动图主动脉瓣面积和主动脉喷射峰速度的变化、心脏瓣膜手术、主动脉和冠状动脉钙化的变化,以及去磷酸化-过羧化基质Gla-蛋白(dp-ucMGP)的变化。该研究的安全性结局包括全因死亡和心血管事件

从2018年2月1日到2019年3月21日,365名男性被随机分组。平均年龄为71.0(±4.4)岁。干预组和安慰剂组AVC评分的平均(95% CI)升高分别为275 AU (95%CI为225~326 AU)和292 AU (95%CI为246~338 AU)。AVC进展的平均差异为17 AU (95%CI为-86~53 AU;P=0.64)。主动脉瓣面积的平均变化为0.02 cm2 (95%CI为-0.09~0.12 cm2;P=0.78),峰值主动脉喷射速度为0.04 m/s (95%CI为-0.11~0.02 m/s;P=0.21)。MK-7+维生素D治疗组和安慰剂组的主动脉和冠状动脉钙化评分进展无显著差异。心脏瓣膜手术率(1 vs 2;P=0.99)、全因死亡(1 vs 4例;P=0.37)或心血管事件(10 vs 10例患者;P = 0.99)无差异。与安慰剂组患者相比,MK-7+维生素D组患者dp-ucMGP显著降低(-212 pmol/L vs 45 pmol/L;P < 0.001)。

由此可见,在AVC评分为>300 AU的老年男性中,2年的MK-7 +维生素D补充治疗并不能改变AVC的进展。

原始出处:

Axel C.P. Diederichsen,et al.Vitamin K2 and D in Patients With Aortic Valve Calcification: A Randomized Double-Blinded Clinical Trial.Circulation.2022.https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.057008

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