Abstract MP06: Vitamin K Status and Cardiovascular Disease: A Participant-Level Meta-Analysis

Introduction: A role for vitamin K in CVD has been proposed because vitamin K-dependent proteins are present in vascular tissue. In individual cohorts, low vitamin K status has been associated with increased CVD. We conducted a participant-level meta-analysis to summarize the association between circulating vitamin K and CVD in the Framingham Offspring Study, the Health, Aging, and Body Composition Study (Health ABC), and the Multi-ethnic Study of Atherosclerosis (MESA), three cohorts in which circulating vitamin K measures and confirmed cardiovascular events are available. Aim: To determine the association between vitamin K status and CVD in community-dwelling adults, overall and according to CVD risk and known risk factors. Methods: Circulating phylloquinone (vitamin K1) was measured from baseline fasting blood samples in 3626 participants and categorized as ≤0.5 nM, >0.5 - ≤1.0 nM and >1.0 nM. Multivariable Cox proportional hazards models assessed the association between circulating phylloquinone and risk of a composite of CVD and mortality. Results: Among the 3626 participants, mean baseline age was 65±11 yrs; 45% were men and 65% white. There were 1436 composite events over a median of 15.4 years. Participants with circulating phylloquinone < 0.5 nM had a 21% higher risk for CVD and mortality compared to those with >1.0nM [HR(95%CI)=1.21(1.06, 1.38)]. When stratified according to baseline CVD risk and risk factors, those with circulating phylloquinone < 0.5 nM had a 27%-82% higher risk for CVD and mortality outcomes compared to those with >1.0 nM ( Table ). Conclusion: Lower circulating phylloquinone was independently associated with a higher risk for CVD and mortality in community-dwelling adults, and more so among those at risk for CVD. Additional studies are needed to confirm our findings and clarify if segments of the population can derive cardiovascular benefit from improving vitamin K status.