Warfarin and Vascular Calcification

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Presentation transcript:

Warfarin and Vascular Calcification Timothy J. Poterucha, MD, Samuel Z. Goldhaber, MD The American Journal of Medicine Volume 129, Issue 6, Pages 635.e1-635.e4 (June 2016) DOI: 10.1016/j.amjmed.2015.11.032 Copyright © 2016 Elsevier Inc. Terms and Conditions

Figure 1 Diagram illustrating the interaction of matrix gamma-carboxyglutamate Gla protein (MGP) and warfarin. MGP has 5 gamma-carboxyglutamate residues, which must be carboxylated by a vitamin K-dependent process into its active form. The activated form of MGP is then able to scavenge calcium phosphate in blood vessels and tissues to prevent calcification. The activated gamma-carboxyglutamate residues are represented by the 5 dark black circles on the right. Warfarin interferes with the activity of MGP by inhibiting the vitamin K-dependent carboxylation reaction, eventually leading to systemic calcification. The American Journal of Medicine 2016 129, 635.e1-635.e4DOI: (10.1016/j.amjmed.2015.11.032) Copyright © 2016 Elsevier Inc. Terms and Conditions

Figure 2 Computed tomography scan of the chest in a 59-year-old woman on warfarin. This patient had a longstanding history of pulmonary embolism and no other vascular risk factors and had been treated with warfarin for 30 years. This scan shows significant calcification of the left anterior descending artery and the left and right bronchi. The American Journal of Medicine 2016 129, 635.e1-635.e4DOI: (10.1016/j.amjmed.2015.11.032) Copyright © 2016 Elsevier Inc. Terms and Conditions