Vitamin D Deficiency is Associated with Severity of Acute Coronary Syndrome in Patients with Type 2 Diabetes and High Rates of Sun Exposure

Abstract

BACKGROUNDVitamin D deficiency has been associated with cardiovascular risk factors, including type 2 diabetes mellitus (T2DM). Evidence shows that patients with low serum 25-hydroxyvitamin D (25OHD) concentrations have a higher risk of developing coronary artery disease.OBJECTIVEThe objective of this study was to assess vitamin D as a predictor of the severity in diabetics with acute coronary syndrome (ACS).METHODSA total of 166 patients were diagnosed with ACS. Serum 25OHD concentrations were analyzed, and risk factors for ACS were evaluated.RESULTSPatients diagnosed as having acute myocardial infarction with elevation of the ST segment had a higher rate of 25OHD, <20 ng/mL compared to ≥30 ng/mL (47.8% × 13.4%, P = 0.03). Diabetics with vitamin D deficiency had more multivessel lesions in the coronary angiography than non-diabetics (69% × 31.8%, P = 0.007). After adjustments for confounders, serum 25OHD remained associated with more severe disease.CONCLUSIONVitamin D deficiency is associated with more severe ACS and is a predictor of more extensive coronary lesions in patients with T2DM.

Association of Vitamin D Deficiency and Degree of Coronary Artery Disease in Cardiac Patients with Type 2 Diabetes

“…Our results presenting the relationship between low levels of 25(OH)D with MI in patients with significant stenosis in coronary arteries and type 2 diabetes are consistent with other published data [ 68 ]. Although the definition of vitamin D deficiency differs in various studies, it was shown that a low level of 25(OH)D in diabetic patients is related to an increased number of multivessel lesions [ 68 ], a higher risk of cardiac nosocomial death [ 69 ], a higher risk of asymptomatic CAD [ 70 ], a poor glycemic control, and a higher serum level of inflammatory markers [ 71 ]. Gondim et al examined 166 patients with type 2 diabetes diagnosed with ST segment elevation myocardial infarction (STEMI) and observed a higher percentage of vitamin D deficiency (defined as a level below 20 ng/ml) compared to patients without STEMI.…”

Role of Vitamin D in Cardiovascular Diseases

“…Thus, vitamin D deficiency may play a role in MI. It is further supported by a high prevalence of vitamin D deficiency in acute MI patients [54–55]. However, studies have reported no association between vitamin D levels, inflammatory markers, and patients with ACS [56–57].…”

The association of serum vitamin D concentration and ventricular dysfunction among patients with acute coronary syndrome

“… 21 Similarly, another cross-sectional study presented a significant association between serum vitamin D concentrations and ventricular ejection fraction. 22 A link between vitamin D deficiency and the severe outcomes of ACS among patients with diabetes has been suggested by Gondim et al 23 Verdoia et al indicated that low vitamin D concentration is highly associated with adverse outcomes in women suffering from cardiovascular diseases. 24 Survival analysis for 7-year total mortality rate among patients with ACS showed a correlation between vitamin D deficiency and increased rate of mortality.…”