Baseline characteristics of the follow-up population
Variable
Placebo (n = 75)
MK-7 (n = 75)
Age (years)
62 (54–66)
59 (55–65)
Sex (M/F, %)
43/32 (57/43)
46/29 (61/39)
Height (m)
1.71 (1.64–1.79)
1.72 (1.65–1.78)
Weight (kg)
82 (73–92)
81 (72–90)
Vitamin K1 (μg/L)
0.549 (0.410–0.724)
0.597 (0.392–0.762)
Vitamin MK-7 (μg/L)
0.518 (0.352–0.639)
0.499 (0.315–0.775)
dp-ucMGP (pmol/L)
349 (285–402)
329 (273–409)
CAC score (AU)
145 (90–220)
135 (95–221)
Data presented as median and interquartile range (IQR) for continuous variables and as percentages for categorical variables. CAC: coronary artery calcification; AU: Agatston units; MK-7: menaquinone-7; dp-ucMGP: dephosphorylated, uncarboxylated matrix Gla-protein
Declarations
Acknowledgments
The authors wish to thank Dr. Gregory Veldhuizen for his help in the linguistic correction of the manuscript.
Author contributions
LMV, AAK, PWdL: Conceptualization, Methodology, Data curation, Formal analysis, Writing—original draft. LJS: Conceptualization, Methodology, Writing—review & editing. CdH: Data curation, Writing—review & editing. All authors have seen and approved the submitted version.
Conflicts of interest
LJS receives research grants from Gnosis by Lesaffre and Bayer and is the founder and shareholder of Coagulation Profile BV. He has voluntarily refrained from being involved in the analysis of the data. The other authors declare that there are no conflicts of interest.
Ethical approval
The trial was approved by the Ethical Review Committee of the Maastricht University Medical Center [MEC09-2-075, NL27372.068.09].
Consent to participate
Informed consent to participate in the study was obtained from all participants.
Consent to publication
Not applicable.
Availability of data and materials
The data presented in this study are available from the authors at reasonable request.
Funding
This study was supported by a grant from the Dutch Heart Foundation [2010B161]. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Open Exploration maintains a neutral stance on jurisdictional claims in published institutional affiliations and maps. All opinions expressed in this article are the personal views of the author(s) and do not represent the stance of the editorial team or the publisher.
References
Lees JS, Chapman FA, Witham MD, Jardine AG, Mark PB. Vitamin K status, supplementation and vascular disease: a systematic review and meta-analysis.Heart. 2019;105:938–45. [DOI] [PubMed]
Vlasschaert C, Goss CJ, Pilkey NG, McKeown S, Holden RM. Vitamin K Supplementation for the Prevention of Cardiovascular Disease: Where Is the Evidence? A Systematic Review of Controlled Trials.Nutrients. 2020;12:2909. [DOI] [PubMed] [PMC]
Vossen LM, Schurgers LJ, van Varik BJ, Kietselaer BL, Vermeer C, Meeder JG, et al. Menaquinone-7 Supplementation to Reduce Vascular Calcification in Patients with Coronary Artery Disease: Rationale and Study Protocol (VitaK-CAC Trial).Nutrients. 2015;7:8905–15. [DOI] [PubMed] [PMC]
Jespersen T, Møllehave LT, Thuesen BH, Skaaby T, Rossing P, Toft U, et al. Uncarboxylated matrix Gla-protein: A biomarker of vitamin K status and cardiovascular risk.Clin Biochem. 2020;83:49–56. [DOI] [PubMed]
Schurgers LJ, Teunissen KJF, Hamulyák K, Knapen MHJ, Vik H, Vermeer C. Vitamin K–containing dietary supplements: comparison of synthetic vitamin K1 and natto-derived menaquinone-7.Blood. 2007;109:3279–83. [DOI] [PubMed]
Aoun M, Makki M, Azar H, Matta H, Chelala DN. High Dephosphorylated-Uncarboxylated MGP in Hemodialysis patients: risk factors and response to vitamin K2, A pre-post intervention clinical trial.BMC Nephrol. 2017;18:191. [DOI] [PubMed] [PMC]
Lentz KA, Vahlgren J, Hansen D, Plebani M, Fusaro M, Rasmussen LM, et al. Treatment of Vitamin K Deficiency in Hemodialysis Patients – A Pilot Study Comparing Menaquinone-7 Tablets and a Vitamin K Rich Diet.Int J Nephrol Renovasc Dis. 2022;15:267–76. [DOI] [PubMed] [PMC]
Vriese ASD, Caluwé R, Pyfferoen L, Bacquer DD, Boeck KD, Delanote J, et al. Multicenter Randomized Controlled Trial of Vitamin K Antagonist Replacement by Rivaroxaban with or without Vitamin K2 in Hemodialysis Patients with Atrial Fibrillation: the Valkyrie Study.J Am Soc Nephrol. 2020;31:186–96. [DOI] [PubMed] [PMC]
Vrijens B, Geest SD, Hughes DA, Przemyslaw K, Demonceau J, Ruppar T, et al. A new taxonomy for describing and defining adherence to medications.Br J Clin Pharmacol. 2012;73:691–705. [DOI] [PubMed] [PMC]
De Geest S, Zullig LL, Dunbar-Jacob J, Helmy R, Hughes DA, Wilson IB, et al. ESPACOMP Medication Adherence Reporting Guideline (EMERGE).Ann Intern Med. 2018;169:30–5. [DOI] [PubMed] [PMC]
Helmy R, Zullig LL, Dunbar-Jacob J, Hughes DA, Vrijens B, Wilson IB, et al. ESPACOMP Medication Adherence Reporting Guidelines (EMERGE): a reactive-Delphi study protocol.BMJ Open. 2017;7:e013496. [DOI] [PubMed] [PMC]
Menditto E, Cahir C, Malo S, Aguilar-Palacio I, Almada M, Costa E, et al. Persistence as a Robust Indicator of Medication Adherence-Related Quality and Performance.Int J Environ Res Public Health. 2021;18:4872. [DOI] [PubMed] [PMC]
Schurgers LJ, Spronk HMH, Soute BAM, Schiffers PM, DeMey JGR, Vermeer C. Regression of warfarin-induced medial elastocalcinosis by high intake of vitamin K in rats.Blood. 2007;109:2823–31. [DOI] [PubMed]
Kamusheva M, Aarnio E, Qvarnström M, Hafez G, Mucherino S, Potočnjak I, et al. Pan-European survey on medication adherence management by healthcare professionals.Br J Clin Pharmacol. 2024;90:3135–45. [DOI] [PubMed] [PMC]
Walsh CA, Mucherino S, Orlando V, Bennett KE, Menditto E, Cahir C. Mapping the use of Group-Based Trajectory Modelling in medication adherence research: A scoping review protocol.HRB Open Res. 2020;3:25. [DOI] [PubMed] [PMC]
Lane D, Lawson A, Burns A, Azizi M, Burnier M, Jones DJL, et al.; Endorsed by the European Society of Hypertension (ESH) Working Group on Cardiovascular Pharmacotherapy and Adherence. Nonadherence in Hypertension: How to Develop and Implement Chemical Adherence Testing.Hypertension. 2022;79:12–23. [DOI] [PubMed]
Chungchunlam SMS, Moughan PJ. Comparative bioavailability of vitamins in human foods sourced from animals and plants.Crit Rev Food Sci Nutr. 2024;64:11590–625. [DOI] [PubMed]
Cranenburg ECM, Koos R, Schurgers LJ, Magdeleyns EJ, Schoonbrood THM, Landewé RB, et al. Characterisation and potential diagnostic value of circulating matrix Gla protein (MGP) species.Thromb Haemost. 2010;104:811–22. [DOI] [PubMed]
Theuwissen E, Magdeleyns EJ, Braam LAJLM, Teunissen KJ, Knapen MH, Binnekamp IAG, et al. Vitamin K status in healthy volunteers.Food Funct. 2014;5:229–34. [DOI] [PubMed]
Lauridsen JA, Leth-Møller KB, Møllehave LT, Kårhus LL, Dantoft TM, Kofoed KF, et al. Investigating the associations between uncarboxylated matrix gla protein as a proxy for vitamin K status and cardiovascular disease risk factors in a general adult population.Eur J Nutr. 2024;64:17. [DOI] [PubMed] [PMC]
van Onzenoort HA, Verberk WJ, Kessels AG, Kroon AA, Neef C, van der Kuy PH, et al. Assessing medication adherence simultaneously by electronic monitoring and pill count in patients with mild-to-moderate hypertension.Am J Hypertens. 2010;23:149–54. [DOI] [PubMed]
van Onzenoort HA, Neef C, Verberk WW, van Iperen HP, de Leeuw PW, van der Kuy PH. Determining the feasibility of objective adherence measurement with blister packaging smart technology.Am J Health Syst Pharm. 2012;69:872–9. [DOI] [PubMed]