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Prodromal symptoms of vital exhaustion and sleep complaints are increasingly being recognized as important risk indicators for myocardial infarction (MI). In this study, the relationships between vital exhaustion, behavioral characteristics, and MI, and between several sleep complaints and MI were investigated. The subjects were 133 male cases with first MI, 192 male hospital controls, and 133 male neighborhood controls. The instruments used were the Maastricht Questionnaire (vital exhaustion), the Life Styles Questionnaire (sleep complaints, coffee consumption, and current smoking), and the Structured Interview (Type A behavior). All sleep complaints, vital exhaustion, Type A behavior, excessive coffee consumption, and current smoking occurred significantly more often in MI-cases. After controlling for these potential confounders, and age, most sleep complaints retained significant associations with MI, in particular often taking naps during the day and waking up in the morning feeling tired and exhausted. [ABSTRACT FROM PUBLISHER]

Objective: Matrix gamma-carboxyglutamic acid (Gla) protein (MGP), a vitamin K-dependent protein, is a potent in vivo inhibitor of arterial calcification. We hypothesized that low endogenous production of MGP and impaired carboxylation of MGP may contribute to the development or the progression of vascular disease., Methods and Results: Novel conformation-specific antibodies against MGP were used for immunohistochemistry of healthy and sclerotic arteries. In healthy arteries, MGP was mainly displayed around the elastin fibers in the tunica media. The staining colocalized with that for carboxylated MGP, whereas undercarboxylated MGP (ucMGP) was not detected. In atherosclerotic arteries, ucMGP was found in the intima, where it was associated with vesicular structures. In Mönckeberg's sclerosis of the media, ucMGP was localized around all areas of calcification. The results indicate that ucMGP is strongly associated with vascular calcification of different etiologies. In a separate study, serum MGP concentrations in a cohort of 172 subjects who had undergone percutaneous coronary intervention were significantly reduced compared with an apparently healthy population., Conclusions: These data show that impaired carboxylation of MGP is associated with intimal and medial vascular calcification and suggest the essentiality of the vitamin K modification to the function of MGP as an inhibitor of ectopic calcification.