The following is a summary of “Interventions to Attenuate Cardiovascular Calcification Progression: A Systematic Review of Randomized Clinical Trials,” published in the November 2023 issue of Cardiology by Murali et al.

Cardiovascular calcification, a significant marker associated with increased cardiovascular morbidity and mortality, often appears in the arterial walls and heart valves, particularly in aging, diabetes, and chronic kidney disease. The effectiveness of evidence-based interventions in substantially slowing down the progression of cardiovascular calcification remains unclear. In this systematic review of randomized controlled trials, the company evaluated various interventions against placebo, alternative comparators, or standard care methods to attenuate cardiovascular calcification. 

Eligible trials involved participants without chronic kidney disease, and the outcomes were assessed using radiological methods. Diverse interventions were explored among the 49 randomized controlled trials encompassing 9,901 participants. Trials centered around aged garlic extract consistently exhibited promising results in mitigating cardiovascular calcification. However, interventions involving 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors, other lipid-lowering agents, hormone replacement therapies, vitamin K, lifestyle modifications, and omega-3 fatty acids showed no substantial attenuation of cardiovascular calcification. The outcomes from antiresorptive, antihypertensive, antithrombotic, and hypoglycemic agents were varied, with mixed results observed. 

Individual studies focusing on salsalate, folate with vitamin B6 and 12, and dalcetrapib did not demonstrate significant cardiovascular calcification attenuation. Overall, the Cochrane risk of bias analysis indicated a moderate level, and the Grading of Recommendations, Assessment, Development, and Evaluations assessment suggested a moderate certainty of evidence for most analyses. In conclusion, the current clinical trial data do not provide adequate or consistent support for interventions to mitigate cardiovascular calcification. Although aged garlic extract appears promising, further assessment is warranted, considering the evaluated studies’ limited sample sizes and short-term durations.

Source: ahajournals.org/doi/10.1161/JAHA.123.031676