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The relationship between serum vitamin d and bare-metal in-stent restenosis in patients with stable coronary artery disease

Year 2020, Volume: 11 Issue: 4, 237 - 242, 30.09.2020
https://doi.org/10.18663/tjcl.624722
https://izlik.org/JA54GN35BN

Abstract

Aim: It has been shown that low levels of vitamin D are associated with increased cardiovascular risk factors and adverse events. The relationship between serum vitamin D level and bare-metal stent in-stent restenosis was investigated in our study.
Material and Methods: A total of 181 patients with stable coronary artery disease and previously implanted (>3 months) bare-metal stent were included in the study. Two groups were formed according to angiographic results as Group 1 (≥50% in-stent stenosis) and Group 2 (<50% in-stent stenosis). Serum vitamin D measurements were performed by reverse-phase HPLC.
Results: The mean serum vitamin D levels were found to be significantly lower in Group 1 compared to Group 2 (17.7 ± 5.3 ng/ml and 20.9 ± 6.7 ng/ml, p<0.01, respectively) and length of stent was longer in Group 1 compared to Group 2 (18.7 ± 5.3 mm and 17.1 ± 11.2 mm, p<0.01, respectively). In multivariate logistic regression analysis, only low level of serum vitamin D and stent length were independent risk factors for bare-metal in-stent stenosis.
Conclusion: Low level of vitamin D might be related to fibrosis and inflammation resulting in in-stent stenosis. Further studies are warranted to determine whether vitamin D supplementation could prevent progression of stent re-stenosis.

References

  • 1. Casteels K, Waer M, Bouillon R, Depovere J, Valckx D, Laureys J, Mathieu C. 1,25-Dihydroxyvitamin D3 restores sensitivity to cyclophosphamide-induced apoptosis in non-obese diabetic (NOD) mice and protects against diabetes. Clin Exp Immunol 1998; 112: 181-7
  • 2. Martins D, Wolf M, Pan D et al. Prevalence of cardiovascular risk factors and the serum levels of 25-hydroxyvitamin D in the United States: data from the Third National Health and Nutrition Examination Survey. Arch Intern Med 2007; 167: 1159–65.
  • 3. Giovannucci E, Liu Y, Hollis BW, Rimm EB. 25-Hydroxyvitamin D and risk of myocardial infarction in men: a prospective study. Arch Intern Med 2008; 168: 1174–80.
  • 4. Kovesdy CP, Ahmadzadeh S, Anderson JE & Kalantar-Zadeh K. Association of activated vitamin D treatment and mortality in chronic kidney disease. Archives of Internal Medicine 2008; 168: 397–403.
  • 5. Wang TJ, Pencina MJ, Booth SL et al. Vitamin D deficiency and risk of cardiovascular disease. Circulation 2008; 117: 503–11.
  • 6. Repo JM, Rantala IS, Honkanen TT et al. Paricalcitol aggravates perivascular fibrosis in rats with renal insufficiency and low calcitriol. Kidney International 2007; 72: 977–84.
  • 7. Curcio A, Torella D, Indolfi C. Mechanisms of smooth muscle cell proliferation and endothelial regeneration after vascular injury and stenting: approach to therapy. Circ J 2011; 75: 1287-96.
  • 8. Farb A, Weber DK, Kolodgie FD, Burke AP, Virmani R. Morphological predictors of restenosis after coronary stenting in humans. Circulation 2002; 105: 2974–80.
  • 9. Uchida Y, Uchida Y, Matsuyama A, Koga A, Kanai M, Sakurai T. Formation of web- and membrane-like structures on the edges of bare-metal coronary stents. Circ J 2010; 74: 1830–6.
  • 10. Fuke S, Maekawa K, Kawamoto K, Saito H, Sato T, Hioka T, Ohe T. Impaired endothelial vasomotor function after sirolimus-eluting stent implantation. Circ J 2007; 71: 220–5.
  • 11. Wakasugi M, Noguchi T, Inoue M, Kazama Y, Tawata M, Kanemaru Y, Onaya T. Vitamin D3 stimulates the production of prostacyclin by vascular smooth muscle cells. Prostaglandins 1991; 42: 127-36.
  • 12. Artaza JN, Norris KC. Vitamin D reduces the expression of collagen and key profibrotic factors by inducing an antifibrotic phenotype in mesenchymal multipotent cells. J Endocrinol 2009; 200: 207–21.
  • 13. Schleithoff SS, Zittermann A, Tenderich G, Berthold HK, Stehle P, Koerfer R. Vitamin D supplementation improves cytokine profiles in patients with congestive heart failure: a double-blind, randomized, placebo- controlled trial. Am J Clin Nutr 2006; 83: 754–9.
  • 14. Wang L, Manson JE, Song Y, Sesso HD. Systematic review: vitamin D and calcium supplementation in prevention of cardiovascular events. Ann Intern Med 2010;152:315–323.
  • 15. Wynn TA. Common and unique mechanisms regulate fibrosis in various fibroproliferative diseases. J Clin Invest 2007; 117: 524-9.
  • 16. Al Mheid I, Patel R, Murrow J e al. Vitamin D status is associated with arterial stiffness and vascular dysfunction in healthy humans. J Am Coll Cardiol 2011; 58: 186-92.
  • 17. Sugden JA, Davies JI, Witham MD, Morris AD, Struthers AD. Vitamin D improves endothelial function in patients with type 2 diabetes mellitus and low vitamin D levels. Diabet Med 2008; 25: 320-5.
  • 18. Tarcin O, Yavuz DG, Ozben B et al. Effect of vitamin D deficiency and replacement on endothelial function in asymptomatic subjects. J Clin Endocrinol Metab 2009; 94: 4023-30.
  • 19. Motiwala SR, Wang TJ. Vitamin D and cardiovascular disease. Curr Opin Nephrol Hypertens 2011 ;20: 345-53.
  • 20. Scragg RK, Camargo CA Jr, Simpson R. Relation of serum 25-hydroxyvitamin D to heart rate and cardiac work (from the National Health and Nutrition Examination Surveys). Am J Cardiol 2010; 105: 122–8.
  • 21. Pittas AG, Sun Q, Manson JE, Dawson-Hughes B, Hu FB. Plasma 25-hydroxyvitamin D concentration and risk of incident type 2 diabetes in women. Diabetes Care 2010; 33: 2021–3.
  • 22. Melamed ML, Muntner P, Michos ED, Uribarri J, Weber C, Sharma J, Raggi P. Serum 25-hydroxyvitamin D levels and the prevalence of peripheral arterial disease: results from NHANES 2001 to 2004. Arterioscler Thromb Vasc Biol 2008; 28: 1179-85.
  • 23. 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.
  • 24. Schierbeck LL, Jensen TS, Bang U, Jensen G, Køber L, Jensen JE. Parathyroid hormone and vitamin D-markers for cardiovascular and all cause mortality in heart failure. Eur J Heart Fail 2011; 13: 626-32.
  • 25. Akin F, Ayça B, Köse N et al. Serum Vitamin D Levels Are Independently Associated With Severity of Coronary Artery Disease. J Investig Med 2012; 60: 869-73.

Stabil koroner arter hastalığı olan hastalarda serum d vitamini ve çıplak metal stent restenozu arasındaki ilişki

Year 2020, Volume: 11 Issue: 4, 237 - 242, 30.09.2020
https://doi.org/10.18663/tjcl.624722
https://izlik.org/JA54GN35BN

Abstract

Amaç



Düşük
D vitamini düzeylerinin artmış kardiyovasküler risk faktörleri ve yan etkiler
ile ilişkili olduğu gösterilmiştir. Çalışmamızda serum D vitamini düzeyi ile
çıplak metal stent restenozu arasındaki ilişki araştırıldı.



Metod



Çalışmaya
stabil koroner arter hastalığı olan ve daha önce çıplak metal sten implante
edilmiş (> 3 ay) olan toplam 181 hasta dahil edildi. Anjiyografik sonuçlara
göre Grup 1 (≥% 50 stent darlığı) ve Grup 2 (<% 50 stent darlığı) olarak iki
grup oluşturuldu. Serum D vitamini ölçümleri ters faz HPLC ile yapıldı.



Bulgular



Ortalama
serum D vitamini düzeyleri Grup 1'de Grup 2'ye göre anlamlı derecede düşük
bulundu (sırasıyla 17.7 ± 5.3 ng / ml ve 20.9 ± 6.7 ng / ml, p <0.001) ve
stent uzunluğu Grup 1'de Grup 2'ye göre daha uzun bulundu (sırasıyla 18.7 ± 5.3
mm ve 17.1 ± 11.2 mm, p <0.001). Çok değişkenli lojistik regresyon
analizinde, sadece düşük serum D vitamini düzeyi ve stent uzunluğu, çıplak
metal stent restenozu için bağımsız risk faktörleriydi.



Sonuç



Düşük
D vitamini düzeyi stent stentenozuna neden olan fibrozis ve inflamasyonla
ilişkili olabilir. D vitamini takviyesinin stent restenozunu önleyip
önleyemeyeceğini belirlemek için ileri çalışmalar yapılması önerilir.

References

  • 1. Casteels K, Waer M, Bouillon R, Depovere J, Valckx D, Laureys J, Mathieu C. 1,25-Dihydroxyvitamin D3 restores sensitivity to cyclophosphamide-induced apoptosis in non-obese diabetic (NOD) mice and protects against diabetes. Clin Exp Immunol 1998; 112: 181-7
  • 2. Martins D, Wolf M, Pan D et al. Prevalence of cardiovascular risk factors and the serum levels of 25-hydroxyvitamin D in the United States: data from the Third National Health and Nutrition Examination Survey. Arch Intern Med 2007; 167: 1159–65.
  • 3. Giovannucci E, Liu Y, Hollis BW, Rimm EB. 25-Hydroxyvitamin D and risk of myocardial infarction in men: a prospective study. Arch Intern Med 2008; 168: 1174–80.
  • 4. Kovesdy CP, Ahmadzadeh S, Anderson JE & Kalantar-Zadeh K. Association of activated vitamin D treatment and mortality in chronic kidney disease. Archives of Internal Medicine 2008; 168: 397–403.
  • 5. Wang TJ, Pencina MJ, Booth SL et al. Vitamin D deficiency and risk of cardiovascular disease. Circulation 2008; 117: 503–11.
  • 6. Repo JM, Rantala IS, Honkanen TT et al. Paricalcitol aggravates perivascular fibrosis in rats with renal insufficiency and low calcitriol. Kidney International 2007; 72: 977–84.
  • 7. Curcio A, Torella D, Indolfi C. Mechanisms of smooth muscle cell proliferation and endothelial regeneration after vascular injury and stenting: approach to therapy. Circ J 2011; 75: 1287-96.
  • 8. Farb A, Weber DK, Kolodgie FD, Burke AP, Virmani R. Morphological predictors of restenosis after coronary stenting in humans. Circulation 2002; 105: 2974–80.
  • 9. Uchida Y, Uchida Y, Matsuyama A, Koga A, Kanai M, Sakurai T. Formation of web- and membrane-like structures on the edges of bare-metal coronary stents. Circ J 2010; 74: 1830–6.
  • 10. Fuke S, Maekawa K, Kawamoto K, Saito H, Sato T, Hioka T, Ohe T. Impaired endothelial vasomotor function after sirolimus-eluting stent implantation. Circ J 2007; 71: 220–5.
  • 11. Wakasugi M, Noguchi T, Inoue M, Kazama Y, Tawata M, Kanemaru Y, Onaya T. Vitamin D3 stimulates the production of prostacyclin by vascular smooth muscle cells. Prostaglandins 1991; 42: 127-36.
  • 12. Artaza JN, Norris KC. Vitamin D reduces the expression of collagen and key profibrotic factors by inducing an antifibrotic phenotype in mesenchymal multipotent cells. J Endocrinol 2009; 200: 207–21.
  • 13. Schleithoff SS, Zittermann A, Tenderich G, Berthold HK, Stehle P, Koerfer R. Vitamin D supplementation improves cytokine profiles in patients with congestive heart failure: a double-blind, randomized, placebo- controlled trial. Am J Clin Nutr 2006; 83: 754–9.
  • 14. Wang L, Manson JE, Song Y, Sesso HD. Systematic review: vitamin D and calcium supplementation in prevention of cardiovascular events. Ann Intern Med 2010;152:315–323.
  • 15. Wynn TA. Common and unique mechanisms regulate fibrosis in various fibroproliferative diseases. J Clin Invest 2007; 117: 524-9.
  • 16. Al Mheid I, Patel R, Murrow J e al. Vitamin D status is associated with arterial stiffness and vascular dysfunction in healthy humans. J Am Coll Cardiol 2011; 58: 186-92.
  • 17. Sugden JA, Davies JI, Witham MD, Morris AD, Struthers AD. Vitamin D improves endothelial function in patients with type 2 diabetes mellitus and low vitamin D levels. Diabet Med 2008; 25: 320-5.
  • 18. Tarcin O, Yavuz DG, Ozben B et al. Effect of vitamin D deficiency and replacement on endothelial function in asymptomatic subjects. J Clin Endocrinol Metab 2009; 94: 4023-30.
  • 19. Motiwala SR, Wang TJ. Vitamin D and cardiovascular disease. Curr Opin Nephrol Hypertens 2011 ;20: 345-53.
  • 20. Scragg RK, Camargo CA Jr, Simpson R. Relation of serum 25-hydroxyvitamin D to heart rate and cardiac work (from the National Health and Nutrition Examination Surveys). Am J Cardiol 2010; 105: 122–8.
  • 21. Pittas AG, Sun Q, Manson JE, Dawson-Hughes B, Hu FB. Plasma 25-hydroxyvitamin D concentration and risk of incident type 2 diabetes in women. Diabetes Care 2010; 33: 2021–3.
  • 22. Melamed ML, Muntner P, Michos ED, Uribarri J, Weber C, Sharma J, Raggi P. Serum 25-hydroxyvitamin D levels and the prevalence of peripheral arterial disease: results from NHANES 2001 to 2004. Arterioscler Thromb Vasc Biol 2008; 28: 1179-85.
  • 23. 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.
  • 24. Schierbeck LL, Jensen TS, Bang U, Jensen G, Køber L, Jensen JE. Parathyroid hormone and vitamin D-markers for cardiovascular and all cause mortality in heart failure. Eur J Heart Fail 2011; 13: 626-32.
  • 25. Akin F, Ayça B, Köse N et al. Serum Vitamin D Levels Are Independently Associated With Severity of Coronary Artery Disease. J Investig Med 2012; 60: 869-73.
There are 25 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Research Article
Authors

Alparslan Kurtul

Murat Gök

Publication Date September 30, 2020
DOI https://doi.org/10.18663/tjcl.624722
IZ https://izlik.org/JA54GN35BN
Published in Issue Year 2020 Volume: 11 Issue: 4

Cite

APA Kurtul, A., & Gök, M. (2020). The relationship between serum vitamin d and bare-metal in-stent restenosis in patients with stable coronary artery disease. Turkish Journal of Clinics and Laboratory, 11(4), 237-242. https://doi.org/10.18663/tjcl.624722
AMA 1.Kurtul A, Gök M. The relationship between serum vitamin d and bare-metal in-stent restenosis in patients with stable coronary artery disease. TJCL. 2020;11(4):237-242. doi:10.18663/tjcl.624722
Chicago Kurtul, Alparslan, and Murat Gök. 2020. “The Relationship Between Serum Vitamin D and Bare-Metal In-Stent Restenosis in Patients With Stable Coronary Artery Disease”. Turkish Journal of Clinics and Laboratory 11 (4): 237-42. https://doi.org/10.18663/tjcl.624722.
EndNote Kurtul A, Gök M (September 1, 2020) The relationship between serum vitamin d and bare-metal in-stent restenosis in patients with stable coronary artery disease. Turkish Journal of Clinics and Laboratory 11 4 237–242.
IEEE [1]A. Kurtul and M. Gök, “The relationship between serum vitamin d and bare-metal in-stent restenosis in patients with stable coronary artery disease”, TJCL, vol. 11, no. 4, pp. 237–242, Sept. 2020, doi: 10.18663/tjcl.624722.
ISNAD Kurtul, Alparslan - Gök, Murat. “The Relationship Between Serum Vitamin D and Bare-Metal In-Stent Restenosis in Patients With Stable Coronary Artery Disease”. Turkish Journal of Clinics and Laboratory 11/4 (September 1, 2020): 237-242. https://doi.org/10.18663/tjcl.624722.
JAMA 1.Kurtul A, Gök M. The relationship between serum vitamin d and bare-metal in-stent restenosis in patients with stable coronary artery disease. TJCL. 2020;11:237–242.
MLA Kurtul, Alparslan, and Murat Gök. “The Relationship Between Serum Vitamin D and Bare-Metal In-Stent Restenosis in Patients With Stable Coronary Artery Disease”. Turkish Journal of Clinics and Laboratory, vol. 11, no. 4, Sept. 2020, pp. 237-42, doi:10.18663/tjcl.624722.
Vancouver 1.Kurtul A, Gök M. The relationship between serum vitamin d and bare-metal in-stent restenosis in patients with stable coronary artery disease. TJCL [Internet]. 2020 Sept. 1;11(4):237-42. Available from: https://izlik.org/JA54GN35BN