OBJECTIVES The use of vitamin K antagonists (VKA) is associated with the onset of vascular and soft-tissue calcifications. Whether there are more intracranial calcifications under VKA remains unclear. The objective of this study was to determine whether the regular use of VKA in older adults was associated with an increased burden of intracranial calcifications compared with the use of direct oral anticoagulant (DOA). STUDY DESIGN Nineteen patients aged 70 years or more using VKA for more than 3 months and 19 controls (matched for age, gender and indication for anticoagulation) using DOA for more than 3 months were consecutively included in this study. MAIN OUTCOMES MEASURES The burden of intracranial calcifications was graded by an experienced neuroradiologist from 0 (no burden) to 3 (high burden) according to the quantity, size, intensity and confluence of calcifications on computed tomography scan of the brain. Age, gender, frontal assessment battery (FAB) score, hypertension, dyslipidaemia, carotid artery stenosis, kidney failure and indication for anticoagulation were investigated as potential confounders. RESULTS The 19 patients using VKA (median[IQR], 84years[7]; 10females) exhibited a greater burden of falcian calcifications than the 19 controls using DOA (respectively, 2[1] versus 1[2], P = 0.025). Overall, we found that using VKA was directly associated with the global burden of intracranial calcifications (β = 1.54, P = 0.049). No correlation was found with calcifications in sites other than the falx cerebri. CONCLUSIONS The use of VKA was associated with a greater burden of intracranial calcifications compared with the use of DOA, specifically in the falx cerebri. This finding may explain part of the neurocognitive morbidity met with VKA.

中文翻译：

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维生素 K 拮抗剂或直接口服抗凝剂引起的颅内钙化：法国 VIKING 对老年人的研究结果

目的 维生素 K 拮抗剂 (VKA) 的使用与血管和软组织钙化的发生有关。VKA下是否有更多的颅内钙化尚不清楚。本研究的目的是确定与使用直接口服抗凝剂 (DOA) 相比，老年人经常使用 VKA 是否与颅内钙化负担增加有关。研究设计 19 名 70 岁或以上使用 VKA 超过 3 个月的患者和 19 名使用 DOA 超过 3 个月的对照（年龄、性别和抗凝适应症匹配）被连续纳入本研究。主要观察指标颅内钙化的负担由经验丰富的神经放射科医师根据数量、大小、大小从0（无负担）到3（高负担）进行分级。钙化的强度和汇合对大脑计算机断层扫描。年龄、性别、额叶评估电池 (FAB) 评分、高血压、血脂异常、颈动脉狭窄、肾衰竭和抗凝指征被作为潜在的混杂因素进行了调查。结果 使用 VKA 的 19 名患者（中位数 [IQR]，84 岁 [7]；10 名女性）表现出比使用 DOA 的 19 名对照组更大的镰状钙化负担（分别为 2[1] 与 1[2]，P = 0.025）。总体而言，我们发现使用 VKA 与颅内钙化的整体负担直接相关（β = 1.54，P = 0.049）。未发现与大脑镰以外部位的钙化存在相关性。结论 与使用 DOA 相比，使用 VKA 与更大的颅内钙化负担相关，特别是在大脑镰。这一发现可能解释了 VKA 所导致的部分神经认知疾病。