BACKGROUND: Vitamin K is the essential co-factor for activation of matrix Gla-protein (MGP), the natural inhibitor of tissue calcification. Biologically inactive, desphospho-uncarboxylated MGP (dp-ucMGP) is a marker of vascular vitamin K status and is described to predict mortality in patients with heart failure and aortic stenosis. We hypothesized that increased dp-ucMGP might be associated with mortality risk in clinically stable patients with chronic vascular disease. MATERIALS AND METHODS: We examined 799 patients (mean age 65.1 ± 9.3 years) who suffered from myocardial infarction, coronary revascularization or first ischemic stroke (pooled Czech samples of EUROASPIRE III and EUROASPIRE-stroke surveys), and followed them in a prospective cohort study. To estimate the 5-year all-cause and cardiovascular mortality we ascertained vital status and declared cause of death. Circulating dp-ucMGP and desphospho-carboxylated MGP (dp-cMGP) were measured by ELISA methods (IDS and VitaK). RESULTS: During a median follow-up of 2050 days (5.6 years) 159 patients died. In the fully adjusted multivariate Cox proportional hazard model, the patients in the highest quartile of dp-ucMGP (≥ 977 pmol/L) had higher risk of all-cause and cardiovascular 5-year mortality [HRR 1.89 (95% CI, 1.32-2.72) and 1.88 (95% CI, 1.22-2.90)], respectively. Corresponding HRR for dp-cMGP were 1.76 (95% CI, 1.18-2.61) and 1.79 (95% CI, 1.12-2.57). CONCLUSIONS: In patients with overt vascular disease, circulating dp-ucMGP and dp-cMGP were independently associated with the risk of all-cause and cardiovascular mortality. Since published results are conflicting regarding the dp-cMGP, we propose only circulating dp-ucMGP as a potential biomarker for assessment of additive cardiovascular risk.

• Klíčová slova
• Coronary heart disease, Dp-cMGP, Dp-ucMGP, EUROASPIRE, Matrix Gla-protein, Mortality, Secondary prevention, Stroke,
• MeSH
• biologické markery krev   MeSH
• cévní mozková příhoda krev   mortalita   MeSH
• ELISA MeSH
• extracelulární matrix - proteiny krev   chemie   MeSH
• infarkt myokardu krev   mortalita   MeSH
• ischemická choroba srdeční krev   mortalita   MeSH
• Kaplanův-Meierův odhad MeSH
• kardiovaskulární nemoci krev   diagnóza   MeSH
• lidé středního věku MeSH
• lidé MeSH
• matrixový protein Gla MeSH
• nemoci cév krev   mortalita   MeSH
• proporcionální rizikové modely MeSH
• prospektivní studie MeSH
• proteiny vázající vápník krev   chemie   MeSH
• regresní analýza MeSH
• revaskularizace myokardu mortalita   MeSH
• senioři MeSH
• vitamin K metabolismus   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• biologické markery MeSH
• extracelulární matrix - proteiny MeSH
• proteiny vázající vápník MeSH
• vitamin K MeSH