Assessment of long term prognostic value of admission vitamin D level in patients with acute STEMI undergoing primary percutaneous coronary intervention

Year 2018, Volume: 45 Issue: 4, 369 - 377, 13.12.2018

Muhammet Hulusi Satilmisoglu Mehmet Gul Huseyin Altug Cakmak Nilgun Isiksacan Selahattin Turen Ugur Kokturk Emre Yilmaz Muammer Karakayalı Aydin Rodi Tosu

https://doi.org/10.5798/dicletip.497879

Cited By: 1

Abstract

Objective:
Vitamin-D status is very important for optimal function of human body
especially cardiovascular system. The aim of this study was to investigate the
long term prognostic value of admission vitamin D level in acute ST-segment
elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary
intervention (PPCI).

Methods:
One hundred fifty seven consecutive patients, who were admitted to a training
and research hospital with a diagnosis of STEMI and underwent PPCI, were
recruited in this prospective study. The study patients were divided into 2
groups according to their vitamin-D levels as follows: High vitamin-D group
(n=80) and Low vitamin-D group (n=77). The severity of coronary artery disease
(CAD) was assessed with calculation of the SYNTAX score.

Results:
There were significant negative correlations between Vitamin-D level and SYNTAX
score, serum glucose, and gender, but a positive correlation with hemoglobin
level. Cardiovascular mortality was found to be significantly higher in the low
vitamin-D group as compared to the high group (p<0.001). In multivariate
analysis, low vitamin-D level was found as a significant independent predictor
of long term cardiovascular mortality after adjusting for other risk factors.

Conclusion:
We demonstrated that low admission vitamin-D is related to severity of CAD.
Vitamin-D deficiency is an independent predictor for long term cardiovascular
mortality in acute STEMI undergoing PPCI.

Keywords

Vitamin D; Mortality; SYNTAX score.

References

• 1. Lee JH, O'Keefe JH, Bell D, et al. Vitamin D deficiency an important, common, and easily treatable cardiovascular risk factor?.J Am Coll Cardiol. 2008; 52: 1949-56.
• 2. Li YC. Vitamin D regulation of the renin-angiotensin system. J Cell Biochem. 2003; 88: 327–31.
• 3. Ortega A, Pérez de Prada MT, Mateos-Cáceres PJ, et al. Effect of parathyroidhormone- related protein on human platelet activation. Clinical Science. 2007; 113: 319–27.
• 4. Pittas AG, Lau J, Hu FB, et al. The role of vitamin D and calcium in type 2 diabetes: a systematic review and meta-analysis. J Clin Endocrinol Metab. 2007; 92: 2017–29.
• 5. Lee JH1, Gadi R, Spertus JA, el al. Prevalence of vitamin D deficiency in patients with acute myocardial infarction. Am J Cardiol. 2011; 107: 1636-8.
• 6. Holick MF. Vitamin D deficiency. N Engl J Med. 2007; 357: 266-81. Review.
• 7. Zittermann A, Kuhn J, Dreier J, et al. Vitamin D status and the risk of major adverse cardiac and cerebrovascular events in cardiac surgery. Eur Heart J. 2013; 34: 1358-64.
• 8. Wang TJ1, Pencina MJ, Booth SL, et al. Vitamin D deficiency and risk of cardiovascular disease. Circulation. 2008; 117: 503-11.
• 9. Khalili H, Talazaz AH, Salarifar M. Serum vitamin D concentration status and its correlation with early biomarkers of remodeling following acute myocardial infarction. Clinical Res Cardiology. 2012; 101: 321–7.
• 10. Pilz S, März W, Wellnitz B, et al. Association of Vitamin D deficiency with heart failure and sudden cardiac death in a large cross sectional study of patient referred for coronary angiography. J Clin Endocrinol Metab. 2008; 93: 3927–35.
• 11. De Metrio M, Milazzo V, Rubino M, et al. Vitamin D plasma levels and in-hospital and 1-year outcomes in acute coronary syndromes: a prospective study. Medicine (Baltimore). 2015; 94: e857.
• 12. Correia LC1, Sodré F, Garcia G, et al. Relation of severe deficiency of vitamin D to cardiovascular mortality during acute coronary syndromes. Am J Cardiol. 2013; 111: 324-7.
• 13. Naesgaard PA, León De La Fuente RA, Nilsen ST, et al. Serum 25 (OH) D is a 2-year predictor of all-cause mortality, cardiac death and sudden cardiac death in chest pain patients from Northern Argentina. PLoS One. 2012; 7: e43228.
• 14. Ünal T,N Çayır A, Kaya A. Is low serum 25(OH) vitamin D a risk factor for childhood pneumonias?. Dicle Medical Journal. 2012; 39: 531-5.
• 15. Demer LL, Hsu JJ, Tintut Y. Steroid Hormone Vitamin D: Impliations for Cardiovascular Disease. Circ Res. 2018; 22: 1576-85.
• 16. Kilkkinen A, Knekt P, Aro A, et al. Vitamin D status and the risk of cardiovascular disease death. Am J Epidemiol. 2009; 170: 1032-9.
• 17. Wang TJ1, Pencina MJ, Booth SL, et al. Vitamin D deficiency and risk of cardiovascular disease. Circulation. 2008; 117: 503-11.
• 18. Ng LL, Sandhu JK, Squire IB, et al. Vitamin D and prognosis in acute myocardial infarction. Int J Cardiol. 2013; 168: 2341-6.
• 19. Dobnig H, Pilz S, Scharnagl H, et al. Independent association of low serum 25- hydroxyvitamin d and 1,25-dihydroxyvitamin d levels with all-cause and cardiovascular mortality. Arch Intern Med. 2008; 168: 1340-9.
• 20. Khalili H, Talasaz AH, Salarifar M. Serum vitamin D concentration status and its correlation with early biomarkers of remodeling following acute myocardial infarction. Clin Res Cardiol. 2012; 101: 321-7.
• 21. Lavie CJ, Lee JH, Milani RV. Vitamin D and cardiovascular disease will it live up to its hype? J Am Coll Cardiol. 2011; 58: 1547-56.
• 22. Ozturk G, Bulut E, Akyol S, et al. The effect of serum 25(OH) vitamin D on hemogram parameters. Dicle Medical Journal. 2014; 41: 332-6.
• 23. Kinlay S, Ganz P. Relation between endothelial dysfunction and the acute coronary syndrome: implications for therapy. Am J Cardiol. 2000; 86: 10J-13J; discussion 13J-14J.Review.