To evaluate the role of plasma vitamin D level as a prognostic marker and its relation to in-hospital complications in patients with acute coronary syndrome

Abstract

Background: Deficiency in 25-hydroxyvitamin D (25[OH] D), the main circulating form of vitamin D in blood, could be involved in the pathogenesis of acute coronary syndromes (ACS). To date, however, the possible prognostic relevance of 25 (OH) D deficiency in ACS patients remains poorly defined. The purpose of this study was to assess the association between 25 (OH) D levels, at hospital admission, with in-hospital complications in an unselected cohort of ACS patients. Methods: We measured 25 (OH) D in 200 ACS patients at hospital presentation. Vitamin D serum levels >30 ng/mL were considered as normal; levels between 29 and 21 ng/mL were classified as insufficiency, and levels < 20 ng/mL as deficiency. In-hospital complications were evaluated according to 25 (OH) D levels. Results: In the study population 85(42.5%) patients had normal 25 (OH) D levels, whereas 36 (18%) and 79 (39.5%) had vitamin D insufficiency and deficiency, respectively. The patients with vitamin D deficiency were associated with a higher risk for several in-hospital MACEs (major adverse clinical events) including mortality and it was statistically significant (P value < 0.05). The left ventricular function was more severely compromised in patients with vitamin D deficiency and it was statistically significant (P value < 0.05). Conclusions: In ACS patients, severe vitamin D deficiency is independently associated with poor in-hospital outcomes. Whether low vitamin D levels represent a risk marker or a risk factor in ACS remains to be elucidated.

Association of Serum Vitamin D level with in-hospital Outcome in Patients with Acute Myocardial infarction

“…The study showed that 51% patients had adverse in-hospital outcome; 71.1% patients with low vitamin-D level had adverse inhospital outcome whereas 14.3% patients with normal vitamin-D level had adverse in-hospital outcome with significant association (p<0.001). Kumar, et al, (2016) showed that the patients with vitamin D deficiency were associated with a higher risk for several in-hospital MACEs, including mortality and it was statistically significant (p-value<0.05) 29 .The study supports the close association between low vitamin D levels at hospital presentation and worse prognosis in ACS patients 29 . Indeed, patients with 25 (OH) D deficiency had a 3-fold higher mortality risk, even after adjustment for important independent variables associated with mortality in ACS 29 .…”

“…Kumar, et al, (2016) showed that the patients with vitamin D deficiency were associated with a higher risk for several in-hospital MACEs, including mortality and it was statistically significant (p-value<0.05) 29 .The study supports the close association between low vitamin D levels at hospital presentation and worse prognosis in ACS patients 29 . Indeed, patients with 25 (OH) D deficiency had a 3-fold higher mortality risk, even after adjustment for important independent variables associated with mortality in ACS 29 . In our study, heart failure was significantly higher in patients with low vitamin D level than patients with normal vitamin D level with significant association (p<0.001).…”

The Role of Toll-Like Receptors and Vitamin D in Cardiovascular Diseases—A Review

“…Another study supported those observations and indicated that vitamin D was independently related to mortality at levels below the population median [ 139 ]. In addition, the left ventricular function was more severely compromised in deficient patients [ 140 ]. Furthermore, the diabetic patients with 25(OH)D deficiency had more extensive coronary lesions [ 141 ].…”