Warfarin inhibits the synthesis and function of
matrix Gla protein, a
vitamin K-dependent
protein, which is a potent inhibitor of tissue calcification. We had earlier reported the association of
warfarin use with valvular calcification in patients with nonvalvular
atrial fibrillation. The aim of our present study was to investigate the association of
warfarin use with the presence and severity of coronary artery calcification. A total of 233 patients underwent computed tomography scan (CT) at our institution for the assessment of coronary artery
calcium score (CACS). Of 233 patients, the mean age was 63 years, 28 patients (12%) were treated with
warfarin, and 205 patients (88%) were not on
warfarin. Based on their total CACS, the patients were subsequently stratified into 59 with no coronary
calcium (CACS = 0), 63 with low CACS (1-100), 49 with moderate CACS (101-400), 33 with severe CACS (410-1000), and 29 with very severe CACS (>1000). The χ test and Student t-test were used for the comparison of categorical and continuous variables, respectively, between
warfarin users and nonusers. Using the variables age, gender, race, smoking,
hypertension, diabetes,
dyslipidemia, glomerular filtration rate,
calcium-
phosphorus product,
alkaline phosphatase, use of
aspirin, beta blockers,
angiotensin-converting enzyme inhibitors or
angiotensin receptor blockers, and
statins, stepwise logistic regression analysis did not show any association of coronary calcification with use of
warfarin. In our study,
warfarin use was not associated with a higher prevalence or severity of CACS assessed by coronary computed tomography.