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

Ianthe Piscaer*, Emiel F. M. Wouters, Cees Vermeer, Wim Janssens, Frits M. E. Franssen, Rob Janssen

*Corresponding author for this work

Research output: Contribution to journalEditorialAcademicpeer-review

10 Citations (Web of Science)

Abstract

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.

Original languageEnglish
Article number189
Number of pages7
JournalRespiratory Research
Volume18
DOIs
Publication statusPublished - 13 Nov 2017

Keywords

  • COPD
  • Cardiovascular diseases
  • Desmosine
  • Elastin
  • Matrix Gla protein
  • Vascular calcification
  • Vitamin K
  • Vitamin K antagonists
  • MATRIX GLA-PROTEIN
  • OBSTRUCTIVE PULMONARY-DISEASE
  • HEALTHY POSTMENOPAUSAL WOMEN
  • CORONARY-HEART-DISEASE
  • ATRIAL-FIBRILLATION
  • ARTERIAL STIFFNESS
  • AORTIC CALCIFICATION
  • ELASTIN DEGRADATION
  • SUPPLEMENTATION
  • RISK

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