New to forum, but not new to heart valves..

[pchanson]

Good morning


yes, and I happen to side with a majority of that plethora in that particular field, not least because its the majority. I do not side with the studies which are ignored by mainstream in this field.

Personally, I have no opinion on how K2 effects calcium plaques, but I do have the opinion that eating a balanced diet and engaging in regular active exersize is good for you. I make no predictions I only identify shortcomings in studies which are bonkers.

Best Wishes

How many studies would it take? I've probably seen 10 at least that identify warfarin specifically or a lack of K2 that shows it's correlation to artery calcification. Would 20 be enough? 30? 50? You'd find flaws with every one, no matter the methodology.

If any of them are accurate (and I think most of them are) then we should at least look at it. Like I said in my last post, if you're not willing to look at it and haven't tried anything to balance the effect that is fairly apparent in it's occurrence, then you probably aren't the best source for the information I'm seeking.

Paul.

 

[pellicle]

How many studies would it take?

a majority.

However you say:

...or a lack of K2 that shows it's correlation to artery calcification

so since you are unable to be sure if its one or the other, scientifically why would you not then consider the low hanging fruit that lack of K2 is the problem and then take that as a part of your diet?

If any of them are accurate (and I think most of them are) then we should at least look at it.

its not just accuracy, its experimental design. If you design an experiment to have more than one variable which you are testing for you are then unable to decide if its A or B that is causal.

Anecdotally we have run that experiment in our lives and found that almost none of us suffer from this arterial calcification.

Why instead would you not wonder the following:

1. high levels of Lp(a) are strongly associated (almost at the level where we have a causal mechanism) with arterial calcification. So address that (with something known and shown to have a strong impact on Lp(a) like PSK9 inhibitors (link)
2. do you have high Lp(a)
3. do people with high Lp(a) have calcification of which you are concerned?

Experimental design is part of methodology in answering a question. Research is designed (or should be) to answer a highly specific question.

Best Wishes

 

[pchanson]

Hi,

There is enough evidence that warfarin can cause arterial calcification in humans to warrant not just including it in inserts but also black box warnings of this effect. There should also be an announcement from the FDA advising doctors of this effect and to have them caution their patients on warfarin to be watching for signs. Bottom line? I've seen enough evidence over the last couple years that to do anything less would actually be unethical.

Post a study that shows that warfarin does not cause this problem when looked at specifically for this issue and that it's perfectly safe in this regard. You just said a majority, then that's exactly what there should be. I'm only asking for one.

Paul.

 

[pellicle]

Post a study that shows that warfarin does not cause this problem when looked at specifically

this is of course one of the main misunderstandings of science ... its impossible to prove a negative (which is why we rely on proving a positve ... no study has yet done that.

https://factmyth.com/factoids/you-cant-prove-a-negative/

The Absence of Evidence and the Evidence of Absence – What Do People Mean When they Say “You Can’t Prove a Negative”?​

In general, and putting aside those who misunderstand the concept, when people use the phrase “you can’t prove a negative” they mean: you can’t prove negatives with certainty based on the absence of evidence alone (the absence of evidence is not necessarily the evidence of absence).​

​

For example, having no proof of Bigfoot doesn’t prove that he isn’t real with certainty, it just means you can’t find evidence that he is real.​

​

Likewise, it is hard to provide proof that a giant flying invisible unicorn doesn’t exist… because there is no evidence of such a thing and thus our best evidence is an absolute lack of evidence.​

​

We can only “prove” that which there is no evidence for with a high degree of probability (by considering the lack of evidence and some rules of logic).​

​

However, while the above is true (one reason the “you can’t prove a negative” saying has weight to it), the reality is we can’t prove positives very well either.​

​

Most proofs (positive or negative) rely on inductive evidence, and induction necessarily always produces probable conclusions and not certain ones.​

​

So for example, if we had Santa on tape admitting he was Santa… it would still only be very strong evidence (it wouldn’t prove he Santa was real with certainty; our senses could be tricking us, the video could be fake, the person may be lying, we might be in the Matrix, etc).​

​

In other words, we could argue that proving both positives and negatives rely on likelihood and not certainty.​

and I've just previously given evidence why you can't reliably say that warfarin causes the calcification when

1. there remain significant known factors (that have not been excluded) which are correlated to causing calcification
2. so many people on it don't get calcification so where is the significant evidence beyond "may contribute to in some cases

So basically you are arguing for a belief system not a science system. I call that "Warfarintology"

Best Wishes

 

[pchanson]

Hi,

Yes I know about proving a negative. However, there should still be a study out there on the safety and efficacy of warfarin and one that specifically clears it in the calcification realm. There isn't one because it in fact does cause this issue.

In this one, they don't imply, say maybe, or beat around the bush. They specifically say that this occurs and it's published by a respected peer reviewed journal, the Journal of American medicine:

"The vitamin K antagonist, warfarin, is the most commonly prescribed oral anticoagulant. Use of warfarin is associated with an increase in systemic calcification, including in the coronary and peripheral vasculature. This increase in vascular calcification is due to inhibition of the enzyme matrix gamma-carboxyglutamate Gla protein (MGP). MGP is a vitamin K-dependent protein that ordinarily prevents systemic calcification by scavenging calcium phosphate in the tissues. Warfarin-induced systemic calcification can result in adverse clinical effects. In this review article, we highlight some of the key translational and clinical studies that associate warfarin with vascular calcification."

The conclusion:
"In conclusion, warfarin causes an increase in systemic calcification through its effects on MGP. This calcification can result in arterial and tracheobronchial calcification. In addition, warfarin use has been associated with impaired bone health. Further studies on the long-term vascular and systemic effects of warfarin need to be performed."

Paul.


https://www.amjmed.com/article/S0002-9343(15)30031-0/fulltext

 

[V__]

Wikipedia is not as accurate on information

If you say so.

since it is posted by other source a person

I don't understand your phrase.

, so it has a 100% inaccuracy rate.

I'm very sorry you think so.

 

[V__]

It's their treatment of certain selected topics that has had me concerned.

It stands to reason that not all topics in an encyclopedia would be to your liking, in any encyclopedia.

biased towards the "establishment" line, especially on nutritional and "climate change" topics.

I'd think that any encyclopedia would lean toward a consensus point of view, as opposed to a fringe point of view.

It is correct that sometimes a fringe point of view turns out to be "more correct" than a current prevailing wisdom. And it's true that things are "messier" in political topics. But that doesn't mean that every crackpot idea is worth attention.

 

[pchanson]

Hi,

"It is correct that sometimes a fringe point of view turns out to be "more correct" than a current prevailing wisdom. And it's true that things are "messier" in political topics."

Glad you think so. It's also starting to happen more often that the fringe becomes the actual correct assessment of the facts. The largest reason this is so, in my opinion, is that other relevant facts were either unknown or deliberately hidden. But with the advent of "knowledge at our fingertips" internet, the facts eventually become known, no matter the reason for their obscurity.

Paul.

 

[V__]

"It is correct that sometimes a fringe point of view turns out to be "more correct" than a current prevailing wisdom. And it's true that things are "messier" in political topics."

Glad you think so.

It has been so throughout the whole history of science.

It's also starting to happen more often that the fringe becomes the actual correct assessment of the facts.

With due respect, I don't think this is necessarily correct. There have been quite spectacular misconceptions in the past. The whole scientific process became much more rigorous IMO.

 

[pellicle]

However, there should still be a study out there on the safety and efficacy of warfarin and one that specifically clears it in the calcification realm.

There have been many, people no longer repeat studies about the boiling point of water when it's established.

We have millions of people on warfarin around the world and have done for over 50 years. If it was as you assert the evidence would be self evident in massive differences in arterial calcification vs the general population (who aren't on warfarin). We don't see that.

However, if you believe that warfarin does cause this, I understand that you already have the antidote; vitamin K.

Just include it in your diet and problem solved right?

Or am I missing something in your thesis?

 

[pellicle]

But that doesn't mean that every crackpot idea is worth attention.

How about "every assertion with weak or a paucity of evidence" (to take value judgements out of this) ?

 

[Teapotimus]

Given my experience over the past few years I have to believe there's something to the whole K2 thing.

However, there should still be a study out there on the safety and efficacy of warfarin and one that specifically clears it in the calcification realm.

While this isn't something I've done much research into, nor do I have a favorite side in this debate, it appears there are a number of studies that have reached the 'warfarin causes increased vascular calcification endpoint'.

https://www.ahajournals.org/doi/full/10.1161/ATVBAHA.119.313879
Warfarin significantly accelerates medial arterial calcification in humans. This effect is markedly augmented in end-stage renal disease.

https://www.frontiersin.org/articles/10.3389/fneur.2021.696244/full
Conclusions: Long-lasting warfarin anticoagulation associated with increased calcification of carotid atherosclerotic plaques, particularly in locations known to be the predilection sites of stroke-causing plaques. The clinical significance of this novel finding warrants further investigations.

https://www.ahajournals.org/doi/10....al calcification,5 years of warfarin therapy.
Warfarin use is associated with lower extremity arterial calcification in both men and women independent of age, sex, diabetes status, and other patient characteristics. This may have implications for the choice of therapies for long‐term anticoagulation.

Etc...

 

[pchanson]

Given my experience over the past few years I have to believe there's something to the whole K2 thing.


While this isn't something I've done much research into, nor do I have a favorite side in this debate, it appears there are a number of studies that have reached the 'warfarin causes increased vascular calcification endpoint'.

https://www.ahajournals.org/doi/full/10.1161/ATVBAHA.119.313879
Warfarin significantly accelerates medial arterial calcification in humans. This effect is markedly augmented in end-stage renal disease.

https://www.frontiersin.org/articles/10.3389/fneur.2021.696244/full
Conclusions: Long-lasting warfarin anticoagulation associated with increased calcification of carotid atherosclerotic plaques, particularly in locations known to be the predilection sites of stroke-causing plaques. The clinical significance of this novel finding warrants further investigations.

https://www.ahajournals.org/doi/10....al calcification,5 years of warfarin therapy.
Warfarin use is associated with lower extremity arterial calcification in both men and women independent of age, sex, diabetes status, and other patient characteristics. This may have implications for the choice of therapies for long‐term anticoagulation.

Etc...

Thanks.

I don't have end stage kidney disease, YET. But I do have PKD. There are some interesting characteristics of PKD besides renal cysts. Like mid line hernia's (check). Bicuspid arotic valves (check, partially bicuspid in my case) Diverticulosis/itis (check, noted in several of my scans). What do they all have in common? Defective collagen formations.

I'm suspecting there are many valve patients that also may have this PKD problem, especially ones that had bicuspid valves. Maybe it's all related and maybe warfarin is a bit safer for some than others. But probably not by much due to the mamogram scan study on warfarin and calcium. I view warfarin as a necessary evil. Many other's as a lifesaver. However many of those that think so probably weren't strapped down in a cath lab with a widow maker.

I even think PKD itself is related to defective collagen. The structures in the kidney could be weak from defective collagen and balloon out forming cysts. I even think I saw someone else say this somewhere but I read it well after I had already told my wife I suspected this to be the case.

Thanks again,

Paul.

 

[V__]

How about "every assertion with weak or a paucity of evidence" (to take value judgements out of this) ?

Well, it depends. I don't have a problem with a new hypothesis with a reasonable logic behind it, that is not supported by tests/observations (yet). As long as it's recognized to be a hypothesis, not a "fact", that's perfectly fine. In the context of medicine, this should not be an actionable knowledge.

But sometimes the hypothesis contradicts known body of knowledge. Sometimes it is inconsistent with other (working) reasoning patterns. Sometimes there is no rhythm nor reason.

 

[pchanson]

There have been many, people no longer repeat studies about the boiling point of water when it's established.

We have millions of people on warfarin around the world and have done for over 50 years. If it was as you assert the evidence would be self evident in massive differences in arterial calcification vs the general population (who aren't on warfarin). We don't see that.

However, if you believe that warfarin does cause this, I understand that you already have the antidote; vitamin K.

Just include it in your diet and problem solved right?

Or am I missing something in your thesis?

That's (for like the 4th or 5th time) why I'm here, To find out if anyone has pursued this avenue. I need to know dosages of K2 used, effect on INR and if it helped the calcium scores. Kinda difficult to get that info when there's a gatekeeper around providing an intimidation factor. I've asked nicely at least twice that if you don't fall into this category to pleaser back off. Please do so or my next stop is the admin. I came here for a very specific answer to a very specific question. You don't even like the question and I suspect you don't want any answers eithier that may shatter this protective bubble you seem to have established, I for one am not intimidated by anything or anyone, but others with a possible answer may be. I'll be moving my question to a new topic that's not in the intro forum. Please don't follow me there or this will be moved to a higher authority. Also, there will be no further replies from me to you on any posts you make in this thread, so unless you like wasting keystrokes, don't bother... mate.

Thanks,

Paul.

 

[pellicle]

That's (for like the 4th or 5th time) why I'm here, To find out if anyone has pursued this avenue. I need to know dosages of K2

First time I'm seeing this in the fog of so much errata.

Why didn't you just lead with that rather than all the words and QAnon language? If you'd have lead with:

Does anyone take vitamin K2, if so how much, you'd have probably got answers. If you'd used your powers of investigation instead of so many words you could probably have already found this

https://www.valvereplacement.org/threads/vitamin-k2-and-warfarin.38392/
However even the opening post is probably why some findings identify a correlation between warfarin and calcification: people are given the wrong advice on Vitamin K

To my knowledge nobody has a specific dose. Even with standard stuff like the FDA gets into there is a range.

Good luck

 

[pellicle]

Well, it depends. I don't have a problem with a new hypothesis with a reasonable logic behind it, that is not supported by tests/observations (yet). As long as it's recognized to be a hypothesis, not a "fact",

Same here.

 

[pchanson]

You might want to get it tested, especially in that you had a Widow Maker. Lp(a) is an independent risk factor for heart disease and often is the prime culprit when there is a heart attack. There is really no way to guess what one's level is without testing, as elevated Lp(a) is genetic and is almost completely unaffected by diet or exercise. A person can have very low levels of other lipoproteins, such as LDL and still have elevated Lp(a). In 2022 the European Atherosclerosis Society (EAS) issued a consensus statement for all adults to be tested at least once in their lifetime. I believe the US will soon be adopting this recommendation as well.

• 2022 European Atherosclerosis Society (EAS) consensus statement. Lp(a) level measured at least once in all adults and in youth with a history of ischemic stroke or a family history of premature ASCVD or elevated Lp(a) level and no other known risk factors.
• 2021 CCS dyslipidemia guideline. Measure once in a person's lifetime as part of initial lipid screening.

https://www.acc.org/Latest-in-Cardi... measured at,part of initial lipid screening.

Hi Chuck,

It's been awhile. I have since collected an LPa score and the result is below. I've also sent my cholesterol numbers before and triglycerides. All of them walking out in front of a bus low. My LPa score is eleven where a result of 75 or less is considered optimal. So, if the modern theory of heart disease is accurate, then I should have never been in that cath lab with a widowmaker. Yet I was. When I had the attack, I was on the same meds/vitamins that produced that LPa score and the choleterol/tri numbers I sent before.

So what caused it? Calcium. My CAC score is well over 4,000. I wonder if pellicle will want to continue to poo-poo the warfarin calcium connection now especially for those with PKD. Yeah, I check that box too. Warfarin is killing me because those arteries were wide open when they did an angio prior to valve placement in late 2011. I watched the playback of the vid and they just wooshed when that dye hit. I'm a walking dead man thanks to rat poison. That number is 10 fold what the high risk bar is. Calcium put me in that cath lab where the wasn't a bit of it before the warfarin. Warfarin and it's action against matrix GLA protein needs attention. Desperately and espicially for those with renal dysfunction.

Thanks for your time Chuck.

Paul.