Vitamin D deficiency in patients with acute coronary syndrome: clinically relevant or just a bystander?

    Authors

    • Marijana Knezevic PravecekGeneral Hospital “Dr. J. Bencevic” Slavonski Brod, Slavonski Brod, Croatia
    • General Hospital “Dr. J. Bencevic” Slavonski Brod, Slavonski Brod, Croatia
    • Katica Cvitkušic LukendaGeneral Hospital “Dr. J. Bencevic” Slavonski Brod, Slavonski Brod, Croatia
    • Antonija RaguzGeneral Hospital “Dr. J. Bencevic” Slavonski Brod, Slavonski Brod, Croatia
    • Ivica DunderGeneral Hospital “Dr. J. Bencevic” Slavonski Brod, Slavonski Brod, Croatia
    • General Hospital “Dr. J. Bencevic” Slavonski Brod, Slavonski Brod, Croatia
    • General Hospital “Dr. J. Bencevic” Slavonski Brod, Slavonski Brod, Croatia
    • General Hospital “Dr. J. Bencevic” Slavonski Brod, Slavonski Brod, Croatia

    Abstract

    Aim: The goal of this study was to determine, for the first time in an east European country, the relationship of 25-hydroxyvitamin D (25(OH)D) serum concentration with extent of coronary artery disease and prognosis in patients with acute coronary syndrome (ACS) during a three-year follow up period. (1-3) Patients and Methods: The study included 60 ACS patients hospitalized at cardiology department for ACS between March 2012 and September 2012; and 60 matched controls without ACS. Standard laboratory testing and vitamin D determination were performed in all study patients. In addition, ACS patients underwent coronary angiography and were followed-up for 36 months of ACS for major adverse cardiac events (MACE). Results: Patients with ACS had a statistically significant lower mean 25(OH)D level as compared with control group (35.19 nmol/L vs. 58.08 nmol/L, p<0.001). The lowest mean level of 25(OH)D was recorded in diabetic patients with ACS (30.45 nmol/L). After coronary angiography, ACS patients were divided into three subgroups regarding coronary disease severity: single, double and multiple vessel disease with 25(OH)D serum levels of 36.44 nmol/L, 33.65 nmol/L and 31.70 nmol/L, respectively. Event free survival rate at 36 months in the ACS group was 60%. Patients with a MACE had lower 25(OH)D, but that difference was not statistically significant (32.64 nmol/L vs 37.01 nmol/L in event free patients). Conclusion: There is an association between low serum concentration of 25(OH)D and ACS. Vitamin D level is considerably influenced by diabetes comorbidity. There was no significant association between 25(OH)D and MACE at 36 months in ACS patients.

    Keywords

    acute coronary syndrome, coronary angiography, 25-hydroxyvitamin D, diabetes, Vitamin D deficiency

    DOI

    https://doi.org/10.15836/ccar.2015.204

    Literature

    1. Naesgaard PA, Pönitz V, Aarsetoey H, Brügger-Andersen T, Grundt H, Harris WS, et al. Prognostic utility of vitamin D in acute coronary syndrome patients in coastal Norway. Dis Markers. 2015;2015:283178. https://doi.org/10.1155/2015/283178
    2. Belen E, Tipi FF, Aykan AC, Findikçioğlu U, Karakuş G, Yeşil A, et al. Clinical staging in chronic heart failure associated with low vitamin D and elevated parathormone levels. Acta Cardiol. 2014;69:665–71. https://doi.org/10.2143/AC.69.6.1000009
    3. Kienreich K, Tomaschitz A, Verheyen N, Pieber T, Gaksch M, Grübler MR, et al. Vitamin D and cardiovascular disease. Nutrients. 2013;5:3005–21. https://doi.org/10.3390/nu5083005
    Cardiologia Croatica
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    Vitamin D deficiency in patients with acute coronary syndrome: clinically relevant or just a bystander?

    Abstract
    Issue9-10
    Published
    Pages204
    PDF via DOIhttps://doi.org/10.15836/ccar.2015.204
    acute coronary syndrome
    coronary angiography
    25-hydroxyvitamin D
    diabetes
    Vitamin D deficiency

    Authors

    Marijana Knezevic Pravecek*General Hospital “Dr. J. Bencevic” Slavonski Brod, Slavonski Brod, Croatia
    Irzal HadzibegovicORCIDGeneral Hospital “Dr. J. Bencevic” Slavonski Brod, Slavonski Brod, Croatia
    Katica Cvitkušic LukendaGeneral Hospital “Dr. J. Bencevic” Slavonski Brod, Slavonski Brod, Croatia
    Antonija RaguzGeneral Hospital “Dr. J. Bencevic” Slavonski Brod, Slavonski Brod, Croatia
    Ivica DunderGeneral Hospital “Dr. J. Bencevic” Slavonski Brod, Slavonski Brod, Croatia
    Krešimir GabaldoORCIDGeneral Hospital “Dr. J. Bencevic” Slavonski Brod, Slavonski Brod, Croatia
    Deiti PrvulovicORCIDGeneral Hospital “Dr. J. Bencevic” Slavonski Brod, Slavonski Brod, Croatia
    Bozo VujevaORCIDGeneral Hospital “Dr. J. Bencevic” Slavonski Brod, Slavonski Brod, Croatia

    *Correspondence email: marijana@aip.hr

    Abstract

    Aim: The goal of this study was to determine, for the first time in an east European country, the relationship of 25-hydroxyvitamin D (25(OH)D) serum concentration with extent of coronary artery disease and prognosis in patients with acute coronary syndrome (ACS) during a three-year follow up period. (1-3) Patients and Methods: The study included 60 ACS patients hospitalized at cardiology department for ACS between March 2012 and September 2012; and 60 matched controls without ACS. Standard laboratory testing and vitamin D determination were performed in all study patients. In addition, ACS patients underwent coronary angiography and were followed-up for 36 months of ACS for major adverse cardiac events (MACE). Results: Patients with ACS had a statistically significant lower mean 25(OH)D level as compared with control group (35.19 nmol/L vs. 58.08 nmol/L, p<0.001). The lowest mean level of 25(OH)D was recorded in diabetic patients with ACS (30.45 nmol/L). After coronary angiography, ACS patients were divided into three subgroups regarding coronary disease severity: single, double and multiple vessel disease with 25(OH)D serum levels of 36.44 nmol/L, 33.65 nmol/L and 31.70 nmol/L, respectively. Event free survival rate at 36 months in the ACS group was 60%. Patients with a MACE had lower 25(OH)D, but that difference was not statistically significant (32.64 nmol/L vs 37.01 nmol/L in event free patients). Conclusion: There is an association between low serum concentration of 25(OH)D and ACS. Vitamin D level is considerably influenced by diabetes comorbidity. There was no significant association between 25(OH)D and MACE at 36 months in ACS patients.

    Literature

    1. 1.
      Naesgaard PA, Pönitz V, Aarsetoey H, Brügger-Andersen T, Grundt H, Harris WS, et al. Prognostic utility of vitamin D in acute coronary syndrome patients in coastal Norway. Dis Markers. 2015;2015:283178.DOI
    2. 2.
      Belen E, Tipi FF, Aykan AC, Findikçioğlu U, Karakuş G, Yeşil A, et al. Clinical staging in chronic heart failure associated with low vitamin D and elevated parathormone levels. Acta Cardiol. 2014;69:665–71.DOI
    3. 3.
      Kienreich K, Tomaschitz A, Verheyen N, Pieber T, Gaksch M, Grübler MR, et al. Vitamin D and cardiovascular disease. Nutrients. 2013;5:3005–21.DOI