A 2-year, double-blind, randomized, placebo-controlled trial published in JAMA Cardiology1has found that daily supplementation with menaquinone-7, a form of vitamin K2, was associated with approximately 29% less progression of coronary artery calcification compared with placebo in patients with mild coronary artery disease.
The study, which used a 360 mcg daily dose of the MenaQ7 ingredient manufactured by Gnosis by Lesaffre, represents one of the most rigorously designed trials to date examining vitamin K2’s role in vascular calcification. For finished product manufacturers in the cardiovascular supplement space, the publication in a high-impact peer-reviewed journal provides a substantially strengthened evidentiary anchor for MK-7 formulations targeting heart health.
“Even still, the findings are remarkable as we currently do not have any effective treatments to address the issue of vascular calcification,” noted Hogne Vik, MD, PhD, MBA, medical and scientific advisor at Gnosis by Lesaffre and a member of the company’s Vitamin K2 Scientific Advisory Committee in a press release.2″This scientific rationale has helped drive continued expert interest in MK-7, including clinical studies in patients with advanced coronary artery calcification.”
What Did the JAMA Cardiology MK-7 Coronary Artery Calcification Trial Find?
The trial, known as the VitaK-CAC study, enrolled 180 men and women with pre-existing coronary artery disease and baseline Agatston coronary artery calcification scores between 50 and 400. Participants were randomized to 360 mcg per day of MK-7 or placebo for 24 months. The primary imaging endpoint was progression of coronary artery calcification as measured by the Agatston score, a widely used computed tomography-based metric of calcified plaque burden.¹
At 24 months, the MK-7 group showed approximately 29% less progression in Agatston score compared with placebo. A consistent trend was observed for calcium mass score, considered a more precise marker of the calcification process than calcium volume, where the MK-7 group demonstrated approximately 42% less progression versus placebo. The authors stated, “As both the Agatston and the calcium mass score pointed in the same direction, we are confident that MK-7 can slow down coronary calcification.”
The MK-7 group also showed improved extrahepatic vitamin K status, with lower levels of dephosphorylated uncarboxylated matrix Gla protein, a validated biomarker of vitamin K-dependent calcification inhibition, alongside increased circulating MK-7 levels.
Two characteristics of the study population are worth noting for context: 78% of participants were on statin therapy, and 67–74% were current or former smokers. Statins are known to stabilize plaques and can promote calcification, raising coronary artery calcification scores even in the absence of disease progression, while active and past smoking is independently associated with accelerated coronary artery calcification.3
These factors likely influenced the calcification trajectory in both groups and should be considered when interpreting the magnitude of between-group differences.
What Is the Disease Burden Associated with Coronary Artery Calcification?
Coronary artery calcification reflects calcified plaque buildup in the heart’s arterial walls, rendering them stiffer and less compliant. It serves as a well-established imaging biomarker of atherosclerosis and an independent predictor of cardiovascular events including myocardial infarction and cardiac death.4 Certain calcification patterns are also associated with plaque vulnerability and rupture risk, making calcification progression an outcome of both diagnostic and therapeutic significance.
The mechanism underlying the trial hypothesis centers on matrix Gla protein, a vitamin K-dependent inhibitor of vascular calcification. When vitamin K status is insufficient, matrix Gla protein remains in its inactive, uncarboxylated form and cannot perform its calcification-inhibiting function.
“Both preclinical and clinical studies have shown that inhibition of the vitamin K-cycle by vitamin K antagonists results in elevated uncarboxylated matrix Gla protein and in extensive arterial calcification,” said Leon Schurgers, professor of biochemistry of vascular calcification and chair of the Department of Biochemistry at the Cardiovascular Research Institute Maastricht, Maastricht University, and one of the lead researchers on the study. “This led us to hypothesize that supplementation with MK-7 can slow down the progression of coronary artery calcification.”
Prior research using MenaQ7 has demonstrated that MK-7 supplementation improves extrahepatic vitamin K status and supports arterial elasticity in postmenopausal women, providing a mechanistic foundation consistent with the new findings.5
What Limitations and Unanswered Questions Remain?
The trial was conducted in a symptomatic, predominantly statin-treated and smoking-exposed population, which limits the generalizability of findings to lower-risk individuals. The study was also not powered to detect differences in hard clinical endpoints such as myocardial infarction or cardiovascular mortality — coronary artery calcification progression served as a surrogate imaging endpoint rather than a direct measure of clinical outcomes. Whether attenuation of coronary artery calcification progression at this magnitude translates to a reduction in cardiovascular events remains an open and clinically important question.¹ The 360 mcg daily dose used in this trial is substantially higher than doses evaluated in prior MK-7 bone health research, and the dose-response relationship for cardiovascular endpoints has not been fully characterized.
References
1. Vossen LM, de Leeuw PW, Schurgers LJ, et al. Two years of menaquinone-7 supplementation and coronary artery calcification: a randomized clinical trial. JAMA Cardiol. Published online June 10, 2026. doi:10.1001/jamacardiology.2026.2850256
2. New MenaQ7 K2 Cardiovascular Study Publishes. Gnosis by Lesaffre. June 11, 2026. Accessed June 12, 2026. Press release provided via email.
3. Henein MY, Granåsen G, Wiklund U, et al. High dose and long-term statin therapy accelerate coronary artery calcification. Int J Cardiol. 2015;184:581–586. doi:10.1016/j.ijcard.2015.02.072
4. McClelland RL, Chung H, Detrano R, Post W, Kronmal RA. Distribution of coronary artery calcium by race, gender, and age: results from the Multi-Ethnic Study of Atherosclerosis. Am J Cardiol. 2006;97(1):25–30. doi:10.1016/j.amjcard.2005.07.054
5. Knapen MH, Braam LA, Drummen NE, Bekers O, Hoeks AP, Vermeer C. Menaquinone-7 supplementation improves arterial stiffness in healthy postmenopausal women: a double-blind randomised clinical trial. Thromb Haemost. 2015;113(5):1135–1144. doi:10.1160/TH14-08-0675