Vitamin D Deficiency in Acute Coronary Syndrome - Clinically Relevant or Incidental Finding?

Cent Eur J Public Health. 2017 Sep;25(3):185-190. doi: 10.21101/cejph.a4577.

Abstract

Objective: Vitamin D deficiency has been associated with cardiovascular disease. The aim of this study was to determine serum concentration of 25 hydroxyvitamin D (25(OH)D) in patients with acute coronary syndrome (ACS) and to assess the prognostic role of serum vitamin D level in ACS patients during 3-year follow up.

Methods: The study included 60 ACS patients hospitalized at cardiology department for ACS between March 2012 and October 2012, and 60 age- and sex-matched control patients without ACS. Standard laboratory testing and vitamin D determination were performed in all study patients. In addition, ACS patients underwent coronarography and were followed-up for 36 months of ACS for major adverse cardiac events (MACE).

Results: Patients with ACS had a statistically significantly 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). ACS patients were divided into three subgroups according to coronarography findings: single vessel, double vessel and triple vessel coronary artery disease (CAD) with respective serum levels of 25(OH)D of 36.44 nmol/L, 33.65 nmol/L and 31.70 nmol/L. During 36-month follow up, the event-free survival rate was 60% in the ACS group. The ACS patients having sustained MACE during follow up had low serum level of 25(OH)D in the acute phase; however, the difference from ACS patients without MACE during follow up did not reach statistical significance (32.64 nmol/L vs. 37.01 nmol/L).

Conclusions: Patients with ACS have low vitamin D level, which is lowest in diabetic patients with ACS. However, during 3-year follow up, vitamin D failed to prove useful as a prognostic biomarker in ACS patients.

Keywords: 25-hydroxyvitamin D; acute coronary syndrome; coronary angiography; diabetes; vitamin D deficiency.

MeSH terms

  • Acute Coronary Syndrome / blood
  • Acute Coronary Syndrome / epidemiology*
  • Adult
  • Aged
  • Causality
  • Comorbidity
  • Croatia / epidemiology
  • Female
  • Follow-Up Studies
  • Humans
  • Incidental Findings*
  • Male
  • Middle Aged
  • Vitamin D / analogs & derivatives
  • Vitamin D / blood
  • Vitamin D Deficiency / blood
  • Vitamin D Deficiency / epidemiology*

Substances

  • Vitamin D
  • 25-hydroxyvitamin D