Coronary artery disease and its association with Vitamin D deficiency

Abstract

Coronary artery disease (CAD) has become the latest scourge of humankind and referred to in this article as CAD, is the end result of the accumulation of atheromatous plaques within the walls of coronary arteries that supply the myocardium, a process also known as atherosclerosis and manifests mostly in the form of chronic stable angina or acute coronary syndrome. Vitamin D has attracted considerable interest recently due to its role in a number of extraskeletal disease processes including multiple sclerosis, malignancies, diabetes mellitus, and CAD. It is also known as sunshine vitamin due to its production in the body following exposure to ultraviolet rays, and it is a unique vitamin as it acts like a hormone with its receptor present in a wide range of tissues including endothelium, which is the important mediator of atherosclerosis and subsequent CAD. A large number of studies conducted in the past have provided the basic scientific framework and this article attempts to explore the role of Vitamin D deficiency in the pathogenesis of CAD and stresses the need for further research to fill up gap in our knowledge.

Vitamin D and Ischaemic Heart Disease: A Casual or A Causal Association?

“…The possible association between vitamin D circulating levels and coronary heart disease was addressed also in other previous recent studies [3][4][5][6][7], however, the issue is intriguing and controversial.…”

“…Vitamin D deficiency may play a crucial role in the pathogenesis of coronary artery disease at several levels, due to the fact that its receptors are present in different tissues. Vitamin D may be involved in the regulation of blood pressure, through different mechanisms, including the renin-angiotensin system and the modulation of vascular smooth muscle cells growth and proliferation [7]: Kawashima have previously shown the presence of a receptor to 1,25-dihydroxyvitamin D in smooth muscle tissue, supporting a potential role for Vitamin D in the regulation of vascular contraction and blood pressure [18]. Some mechanisms that may explain the preventive effects of Vitamin D against hypertension are summarized in Table 1.…”

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“…In addition, vitamin D decreases arterial stiffness by causing upregulation of nitric oxide synthesis in endothelium. Thus, vitamin D helps in preventing hypertension as well as cardiovascular diseases [30]. Interestingly, vitamin D receptor has been identified on the surface of smooth muscle cells, endothelial cells, myocardial cells, inflammatory cells and in platelets, thus, potentially influencing thrombosis.…”

Effects of VDBP and VDR Mutations and Other Factors to the Development of Stent Thrombosis in Coronary Artery Disease Patients

“…Yine aynı çalışmada, ölçülen klopidogrel ve aspirinin bozulmuş trombosit yanıtının ST ve kardiyak ölüm riskinde artışa neden olduğu belirlenmiştir(40). Çalışmamıza dahil olan bireylerin klopidogrel ve aspirin tedavisi gördüğü düşünüldüğünde düşük hemoglobin seviyesi beklenebilecek bir durum ,42,43). Özellikle D vitamininin, VDR ve VDBP proteinlerinin görev aldığı yolaklar yoluyla hastalığın progresyonunu önemli ölçüde etkilediği düşünülmektedir.…”