Can vitamin K2 slow coronary artery calcium? A new JAMA Cardiology randomized trial found that MK-7 may reduce CAC progression over 2 years — but the real story is more complicated.

TL;DR: In this randomized trial, people with symptomatic coronary artery disease and CAC scores between 50–400 took either MK-7, a form of vitamin K2, at 360 mcg daily or placebo for 2 years. The MK-7 group had slower progression of coronary artery calcium and calcium mass, with no major safety signal. But this study did not prove fewer heart attacks, fewer stents, or lower mortality — so this is interesting, not a miracle. Especially important: do not start vitamin K supplements without medical guidance if you take warfarin/Coumadin.

Article link: https://jamanetwork.com/journals/jamacardiology/fullarticle/2850256

In this video, I break down the VitaK-CAC trial: who was studied, what dose was used, what happened to CAC scores, why plaque calcification is biologically complicated, and what I would — and would not — take away from this as a vascular surgeon.

⏰ Chapters
0:00 - New vitamin K study: why this matters
0:39 - The paper: MK-7 and coronary artery calcium
1:42 - Vitamin K1 vs K2, why MK-7
2:13 - What the VitaK-CAC trial tested
3:08 - Calcified plaque vs total plaque burden
3:28 - Study design: randomized, placebo-controlled, double-blind
4:41 - Who was included and excluded in the trial, plus why it matters
6:32 - What “symptomatic CAD” actually meant here
8:47 - The intervention: 360 mcg MK-7 daily
9:13 - CT scans, CAC scoring, and calcium mass
10:59 - How vitamin K status was measured
12:29 - Primary outcome: CAC progression, not heart attacks
13:03 - Statistical methods and “fast progression”
16:44 - LDL levels, statins, and a possible data discrepancy
18:25 - Baseline characteristics of the study population
22:12 - Adherence, adverse events, and vitamin K blood levels
23:31 - Matrix Gla protein: did MK-7 do what it was supposed to?
24:58 - Primary results: CAC progression slowed with MK-7
26:21 - Why the effect is exciting but modest
29:17 - Fast progressors: no significant difference
30:07 - Calcium mass and intention-to-treat analysis
32:02 - Secondary outcomes: plaque type and stenosis
33:32 - The big question: is less calcification always better?
35:40 - Discussion: promising, but clinical significance unknown
37:13 - Why MK-7 does not “remove” existing calcium
38:23 - Vitamin K biomarkers and possible under-dosing
42:25 - Study limitations
43:41 - Funding, conflicts of interest, and final takeaways
44:48 - My clinical take on vitamin K2/MK-7

This video is for education only and is not personal medical advice. Do not start, stop, or change supplements or medications based on YouTube — especially if you take warfarin or any medication affected by vitamin K. Talk with your own clinician.

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🧬 About Dr. Lily Johnston
  
Dr. Johnston is a double board-certified vascular and general surgeon in San Diego, specializing in metabolic and cardiovascular prevention. She’s the founder of CorSight Health and a passionate advocate for reimagining how medicine approaches chronic disease.