Vitamin K(2) and D(3) Supplementation in Patients With Severe Coronary Artery Calcification: The DANCODE Trial.

Vitamin K2 plus vitamin D3 supplementation reduced coronary artery calcification progression over 24 months in 400 patients with severe CAC (between-group difference -52 AU).

• Why it matters: Coronary artery calcification progression strongly predicts cardiovascular events, but it is unclear whether vitamin K2 and vitamin D3 can slow CAC worsening in patients with severe baseline calcification.
• What they did: In a multicenter, double-blind, placebo-controlled randomized trial, 400 participants with CAC score ≥400 AU received vitamin K2 720 μg/d plus vitamin D3 25 μg/d or placebo for 24 months, with noncontrast cardiac CT at baseline, 12 months, and 24 months.
• The result: At 24 months, mean CAC increased 196 AU with vitamin K2 and D3 versus 248 AU with placebo (between-group difference -52 AU), and calcified plaque volume progression was attenuated in CT angiography (between-group difference -8 mm3).