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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

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

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 Orıgınal Artıcle
Authors

Alparslan Kurtul

Murat Gök

Publication Date September 30, 2020
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 Kurtul A, Gök M. The relationship between serum vitamin d and bare-metal in-stent restenosis in patients with stable coronary artery disease. TJCL. September 2020;11(4):237-242. doi:10.18663/tjcl.624722
Chicago 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 11, no. 4 (September 2020): 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 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, 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 2020), 237-242. https://doi.org/10.18663/tjcl.624722.
JAMA 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, 2020, pp. 237-42, doi:10.18663/tjcl.624722.
Vancouver 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):237-42.


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