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Research Progress of Warfarin-associated Vascular Calcification and Its Possible Therapy

Zhang, Yu-Tao MD; Tang, Ze-Yao PhD

Journal of Cardiovascular Pharmacology: January 2014 - Volume 63 - Issue 1 - p 76–82
doi: 10.1097/FJC.0000000000000008
Review Article

Abstract: Vascular calcification is a common comorbidity in elderly patients with diabetes mellitus or renal insufficiency. A large number of studies have shown that vascular calcification can be induced and accelerated in patients undergoing long-term treatment with warfarin, leading to some severe complications, such as hypertension, atherosclerosis, valvular calcification, and coronary calcification, especially in the population with atrial fibrillation, hemodialysis, and chronic kidney disease. Warfarin inhibits the activation of vitamin K–dependent coagulation factors and affects the function of vitamin K–dependent proteins via interference of the vitamin K cycle by antagonizing vitamin K. One of its consequences is adverse effects on the expression and function of matrix Gla protein, one of the important vitamin K–dependent proteins. Matrix Gla protein acts as an inhibitor of vascular calcification by blocking bone morphogenetic protein signaling or promoting the phagocytosis of apoptotic bodies; moreover, it restrains the formation of calcification directly resulting in the promotion of vascular calcification. This article also discusses the various treatments for vascular calcification caused by warfarin.

Department of Pharmacology, Dalian Medical University, Dalian, People's Republic of China.

Reprints: Ze-Yao Tang, PhD, Department of Pharmacology, Dalian Medical University, West Section 9, South Rd, Lushun, Dalian, People's Republic of China 116044 (e-mail:

Supported by the grants of Natural Science Foundation of China (No. 30772601).

The authors report no conflicts of interest.

Received April 24, 2013

Accepted July 26, 2013

© 2014 by Lippincott Williams & Wilkins.