ABSTRACT
OBJECTIVE: To investigate the association of plasma phylloquinone concentrations with coronary artery calcification (CAC) and vascular calcification. APPROACH AND RESULTS: In a prospective cohort of 508 postmenopausal women, plasma phylloquinone concentrations were measured by high-pressure liquid chromatography. Calcification was measured in the coronary arteries, aortic valve, mitral valve, and thoracic aorta by multidetector computed tomography. To combine these calcification scores, we dichotomized each of the 4 areas into present or absent. Because of the continuous measurement of CAC, we categorized this as calcification present if Agatston score was >0, and calcification score was calculated as the sum of the calcified areas. Multivariate-adjusted prevalence ratios and odds ratios were estimated using Poisson regression and multinomial logistic regression. After 8.5 years of follow-up, 22% of the women had no calcification, whereas 5% had calcification in all measured areas. Detectable phylloquinone concentrations were associated with increased CAC compared with nondetectable phylloquinone concentrations with a prevalence ratio of 1.34 (95% confidence interval, 1.01-1.77). When dividing women with detectable phylloquinone concentrations into low detectable (>0-0.70 nmol/L) and moderate to high detectable (>0.70 nmol/L) phylloquinone concentrations versus nondetectable phylloquinone concentrations, both were associated with increased CAC with a prevalence ratio of 1.32 (95% confidence interval, 0.99-1.76) and 1.36 (95% confidence interval, 1.02-1.81), respectively. Detectable phylloquinone concentrations were not associated with the number of calcified areas with an odds ratio(no versus ≥ 3 areas calcifications) of 1.60 (95% confidence interval, 0.65-3.99; P=0.31). CONCLUSIONS: Detectable phylloquinone concentrations are not associated with reduced vascular calcification but seemed to be associated with an increased prevalence of CAC.
Subject(s)
Aortic Diseases/blood , Coronary Artery Disease/blood , Healthy Volunteers , Vascular Calcification/blood , Vitamin K 1/blood , Aged , Aortic Diseases/diagnostic imaging , Aortic Diseases/epidemiology , Aortography/methods , Biomarkers/blood , Chromatography, High Pressure Liquid , Coronary Angiography/methods , Coronary Artery Disease/diagnostic imaging , Coronary Artery Disease/epidemiology , Female , Humans , Logistic Models , Middle Aged , Multidetector Computed Tomography , Multivariate Analysis , Netherlands/epidemiology , Odds Ratio , Postmenopause , Prevalence , Prospective Studies , Risk Factors , Severity of Illness Index , Vascular Calcification/diagnostic imaging , Vascular Calcification/epidemiologyABSTRACT
BACKGROUND: Diet composition is one of the factors that may contribute to intraindividual variability in the anticoagulant response to warfarin. AIM OF THE STUDY: To determine the associations between food pattern and anticoagulant response to warfarin in a group of Brazilian patients with vascular disease. METHODS: Recent and usual food intakes were assessed in 115 patients receiving warfarin; and corresponding plasma phylloquinone (vitamin K(1)), serum triglyceride concentrations, prothrombin time (PT), and International Normalized Ratio (INR) were determined. A factor analysis was used to examine the association of specific foods and biochemical variables with anticoagulant data. RESULTS: Mean age was 59 +/- 15 years. Inadequate anticoagulation, defined as values of INR 2 or 3, was found in 48% of the patients. Soybean oil and kidney beans were the primary food sources of phylloquinone intake. Factor analysis yielded four separate factors, explaining 56.4% of the total variance in the data set. The factor analysis revealed that intakes of kidney beans and soybean oil, 24-h recall of phylloquinone intake, PT and INR loaded significantly on factor 1. Triglycerides, PT, INR, plasma phylloquinone, and duration of anticoagulation therapy loaded on factor 3. CONCLUSIONS: Fluctuations in phylloquinone intake, particularly from kidney beans, and plasma phylloquinone concentrations were associated with variation in measures of anticoagulation (PT and INR) in a Brazilian group of patients with vascular disease.