Coronary disease & ACS

Vitamin K 2 and D 3 Supplementation in Patients With Severe Coronary Artery Calcification: The DANCODE Trial

CirculationPublished Randomised controlled trial

Primary result · CAC increaseResult — go to the resultBetween-group difference −52 AU 95% CI −79 to −24

Authors' conclusion

Among patients with severe CAC, supplementation with vitamin K2 and vitamin D3 reduced progression of CAC over 24 months. The reduction in calcification progression was not associated with an increase in noncalcified plaque volume.

Study context

Population
Patients with severe coronary artery calcification (CAC score ≥400 Agatston units (AU))400 randomised
Participants
398 patients
Comparison
Vitamin K2 plus vitamin D3 vs placebo
Primary endpoint
Change in CAC score
Follow-up
24 months
Methodological detailsmulticentre, double-blind, placebo-controlled
  • Multicentre
  • Double-blind
  • Placebo-controlled

Primary result

CAC increase

Between-group difference

−52 AU

95% CI −79 to −24

Change by group

Vitamin K2 and D3

196

mean · 95% CI 178–214 · AU

Placebo

248

mean · 95% CI 225–271 · AU

Vitamin K2 and D3vs Placebo
between-group difference −52 AU (95% CI −79 to −24)

As reported in the abstract

Further findings

CAC change by sex and baseline CAC (400-999 and ≥1000 AU) (subgroups) · 24 months

Treatment effect consistent across sex and baseline CAC subgroups

Plaque composition on coronary CT angiography (subset with CAC <1000 AU) · 24 months

Calcified plaque volume progression attenuated in the intervention group: between-group difference
−8 mm³ (95% CI, −13 to −2)
Similar increase in total plaque volume between groups
No change in noncalcified plaque volume between groups
  • 143 participants underwent coronary CT angiography

Original publication

Vitamin K 2 and D 3 Supplementation in Patients With Severe Coronary Artery Calcification: The DANCODE Trial. Circulation. Published 28 August 2026. doi:10.1161/circulationaha.126.082363

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