Lower vitamin D level is associated with poor coronary collateral circulation

Şahin, İrfan; Okuyan, Ertuğrul; Güngör, Barış; Kaya, Adnan; Avcı, İlhan İlker; Biter, Halil İbrahim; Çetin, Şükrü; Enhos, Asim; Avsar, Murat; Dinçkal, Mustafa Hakan

doi:10.3109/14017431.2014.940062

Cited by 11 publications

(10 citation statements)

References 29 publications

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“…reported that low vitamin D levels were associated with impaired development of CCC in patients with stable coronary artery disease. However, in that study, only 48% of subjects and in the control group 52% of subjects had a totally occluded coronary artery [ 21 ]. In our study, we enrolled only patients with a CTO, where sufficient CCC has vital importance in maintenance of myocardial function.…”

Section: Discussionmentioning

confidence: 99%

25-Hydroxy-vitamin D level may predict presence of coronary collaterals in patients with chronic coronary total occlusion

Doğan¹,

Şarlı²,

Baktır³

et al. 2015

pwki

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IntroductionSufficient coronary collateral circulation (CCC) protects myocardial tissue against ischemia in patients with coronary chronic total occlusion (CTO). Vitamin D is a steroid hormone which has been related to increased prevalence of hypertension, left ventricular hypertrophy, heart failure, peripheral artery disease, coronary artery disease, myocardial infarction and cardiovascular mortality.AimTo investigate whether there is an association between serum 25-hydroxy-vitamin D levels and development of CCC in patients with coronary CTO.Material and methodsA total of 188 patients with CTO at coronary angiography were included in this study. Vitamin D and parathyroid hormone (PTH) levels were measured on the day of coronary angiography. Development of collateral circulation was graded according to the Rentrop classification after coronary angiography. Then, patients were divided into two groups on the basis of CCC grades: group 1 included 68 (36%) patients with poorly developed CCC, and group 2 included 120 (64%) patients with well-developed CCC.ResultsPatients with poorly developed CCC had significantly lower serum 25-hydroxy-vitamin D levels compared to those with well-developed CCC (20 ±3 vs. 30 ±6 ng/ml, p<0.0001). Multivariate logistic regression analysis indicated serum 25-hydroxyvitamin D (25(OH)D) (OR = 1.794, 95% confidence interval (CI): 1.453–2.216; p<0.001) as an independent predictor of poor collateral flow in patients with CTO.ConclusionsLow vitamin D level is an independent predictor of poor CCC in patients with CTO.

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Section: Discussionmentioning

confidence: 99%

25-Hydroxy-vitamin D level may predict presence of coronary collaterals in patients with chronic coronary total occlusion

Doğan¹,

Şarlı²,

Baktır³

et al. 2015

pwki

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“…The hormonally active form of vitamin D is calcitriol or 1a,25-dihydroxycalciferol D (1a,25(OH) 2 D 3 ). In contrast to 25-hydroxyvitamin D (25(OH)D 3 ), which is a prohormone and the major circulating metabolite of vitamin D, the levels of 1a,25(OH) 2 D 3 are about 1000-fold lower than those of 25(OH)D 3 . Although 1a,25(OH) 2 D 3 portrays the biological active form of vitamin D, it is widely accepted that 25(OH)D is the robust indicator of vitamin D status in individuals, especially in hypovitaminosis or VDD [6].…”

Section: Introductionmentioning

confidence: 96%

“…It has recently been reported that lower vitamin D levels may be associated with poor collateral vasculature development in patients with stable coronary artery disease [3]. The other cross-sectional analyses showed the associations between lower vitamin D levels and the risk of cardiovascular diseases or poor prognosis for patients with major adverse events (MACE) [3][4][5][6]. Moreover, the association between vitamin D deficiency (VDD) and endothelial dysfunction is well established [7].…”

Section: Introductionmentioning

confidence: 99%

Seasonal effect of vitamin D deficiency in patients with acute myocardial infarction

et al. 2016

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A b s t r a c tBackground: Vitamin D is a major regulator of mineral bone metabolism. The lower vitamin D levels in patients with acute myocardial infarction (AMI) and the seasonal variation of vitamin D levels are proposed. Aim:The evaluation of the seasonal relationship of 25(OH)D levels in patients with AMI and analysis of confounding factors (gender or diabetes mellitus) affecting the levels of vitamin D in AMI patients.Methods: Fifty-nine consecutive patients with mean age 58 ± 9.4 years were admitted to the Department of Invasive Cardiology. Subjects had diagnosed uncomplicated myocardial infarction. Blood samples for analysis were collected on patient admission to the cardiac unit after heparin treatment. Samples for routine laboratory tests were immediately processed. For 25(OH)D, the 25-hydroxycholecalciferol test, which measures total vitamin D levels in serum (DRG Instruments GmbH, Marburg, Germany), was applied.Results: Median serum 25(OH)D concentration in AMI patients was below the recommended optimal values 7.1 (2.3-13.3) ng/mL. Fifty-three (89.8%) patients had vitamin D deficiency (VDD) below 20 ng/mL, six (10.2%) patients had suboptimal 25(OH)D levels (between 20 ng/mL and 30 ng/mL), and no one had the recommended reference range. The seasonal effect of 25(OH)D variations among AMI patients was observed with the lowest levels in the beginning of the year (January-March) and the highest levels at the end of the year (September-December) (p = 0.007). Patients with normoglycaemia had significantly higher (9.2 [2.3-16.8] ng/mL) vitamin D levels compared to patients with impaired glucose tolerance (2.3 [2.3-3.9] ng/mL) or diabetes mellitus (8.5 [2.5-13.3] ng/mL) (p = 0.01). Conclusions:A high prevalence of VDD in AMI patients has been confirmed. Supplementation of vitamin D in AMI patients with hyperglycaemia can bring greater benefits.

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“…Several epidemiological studies measuring serum 25(OH)D demonstrate an absence of association with presence or extent of CAC, MAC, cIMT, degree of carotid stenosis or mean arterial pressure 22,[133][134][135] , although patients with calcific aortic stenosis 136 and poor coronary collateral circulation 137 140 and with the calcification score in peripheral arterial disease 27 . Likewise with respect to serum 1,25(OH)2D, some studies show no association with CAC extent or progression 133,141 , although in subjects at risk for CHD, serum 1,25(OH)2D was inversely correlated with the extent of calcification 142 .…”

Section: Ectopic Calcificationmentioning

confidence: 99%

Cardiovascular Calcification and Bone: A Comparison of The Effects of Dietary and Serum Calcium, Phosphorous, Magnesium and Vitamin D

Nicoll¹

2015

ICFJ

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This comparison of the effects of calcium, phosphorus, magnesium and vitamin D on cardiovascular (CV) calcification and bone has shown that in general the micronutrients that promote bone health also protect the arteries. We have shown that adequate amounts of all three minerals should be ingested, paying particular attention to supplementing calcium to bind high phosphorus and to ensure the maximum benefit from supplementing vitamin D. It appears that the optimum intake for bone is >800 mg/d calcium, with postmenopausal women possibly requiring a total intake of >1100mg/d. Both CV and bone studies suggest achieving a serum 25(OH)D level of >75nmol/l. These relationships are valid for a Caucasian population, however, and may not hold in African Americans and Asians. The recent concerns that calcium supplementation may increase CV disease risk has largely proved groundless, with higher calcium intake improving dyslipidaemia, hypertension and mortality. With respect to higher serum phosphate, there is an association with CV calcification and CVD risk even within the normal range, suggesting that the reference ranges may need to be redefined for ‘at risk’ patients. CV calcification was reduced in CKD patients with magnesium intake in the range 384-669mg/d. When considering the complex interplay of the action of the minerals together with their regulators vitamin D, PTH and FGF23, it is clear that this is a very sophisticated system which attempts to maintain calcium homeostasis to the possible detriment of bone and arteries. This reinforces the need to ensure adequate calcium intake before supplementing vitamin D.

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Lower vitamin D level is associated with poor coronary collateral circulation

Abstract: Lower vitamin D levels may be associated with poor collateral development in patients with stable CAD.

Cited by 11 publications

References 29 publications

25-Hydroxy-vitamin D level may predict presence of coronary collaterals in patients with chronic coronary total occlusion

25-Hydroxy-vitamin D level may predict presence of coronary collaterals in patients with chronic coronary total occlusion

Seasonal effect of vitamin D deficiency in patients with acute myocardial infarction

Cardiovascular Calcification and Bone: A Comparison of The Effects of Dietary and Serum Calcium, Phosphorous, Magnesium and Vitamin D

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