Vitamin K2 and D3 Supplementation in Patients With Severe Coronary Artery Calcification: The DANCODE Trial

Hasific S, Øvrehus KA, Mejldal A, Hosbond S, Lambrechtsen J, Kumarathurai P, et al.

Published in Circulation

Methodology

Multicentre, double-blind, placebo-controlled randomised trial in Denmark. 400 adults with a coronary artery calcium (CAC) score of 400 Agatston units or more were assigned to vitamin K2 720 mcg/day plus vitamin D3 25 mcg/day or placebo for 24 months; non-contrast cardiac CT at baseline, 12 and 24 months, and CT angiography in a subset of 143.

Key Findings

Among 398 participants (median age 71, 30% women, median baseline CAC 903 AU), CAC rose by a mean 196 AU with K2 and D3 vs 248 AU with placebo (difference -52 AU, 95% CI -79 to -24), consistent across sex and baseline CAC subgroups. Total plaque volume rose similarly and non-calcified plaque volume did not differ between groups; calcified plaque volume progressed less with supplementation (-8 mm3, 95% CI -13 to -2).

Conclusions

In people with severe coronary calcification, vitamin K2 with vitamin D3 slowed CAC progression over 2 years without an increase in non-calcified plaque volume.

Limitations

Combined K2 and D3, so the effect cannot be attributed to K2 alone. The primary end point is an imaging marker; clinical events were not the primary outcome. The abstract does not report adverse events.