Association of Warfarin Use With Valvular and Vascular Calcification: A Review
Article first published online: 6 FEB 2011
© 2011 Wiley Periodicals, Inc.
Volume 34, Issue 2, pages 74–81, February 2011
How to Cite
Palaniswamy, C., Sekhri, A., Aronow, W. S., Kalra, A. and Peterson, S. J. (2011), Association of Warfarin Use With Valvular and Vascular Calcification: A Review. Clin Cardiol, 34: 74–81. doi: 10.1002/clc.20865
- Issue published online: 4 FEB 2011
- Article first published online: 6 FEB 2011
- Manuscript Accepted: 26 OCT 2010
- Manuscript Received: 1 AUG 2010
Vitamin K is required for the activity of various biologically active proteins in our body. Apart from clotting factors, vitamin K–dependent proteins include regulatory proteins like protein C, protein S, protein Z, osteocalcin, growth arrest-specific gene 6 protein, and matrix Gla protein. Glutamic acid residues in matrix Gla protein are γ-carboxylated by vitamin K–dependent γ-carboxylase, which enables it to inhibit calcification. Warfarin, being a vitamin K antagonist, inhibits this process, and has been associated with calcification in various animal and human studies. Though no specific guidelines are currently available to prevent or treat this less-recognized side effect, discontinuing warfarin and using an alternative anticoagulant seems to be a reasonable option. Newer anticoagulants such as dabigatran and rivaroxaban offer promise as future therapeutic options in such cases. Drugs including statins, alendronate, osteoprotegerin, and vitamin K are currently under study as therapies to prevent or treat warfarin-associated calcification. Copyright © 2011 Wiley Periodicals, Inc.
The authors have no funding, financial relationships, or conflicts of interest to disclose.