Cent Eur J Public Health 2017, 25(3):185-190

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

Marijana Knežević Praveček1, Željka Vuković-Arar2, Blaženka Miškić3, Irzal Hadžibegović1
1 Department of Cardiology, Dr. Josip Benčević General Hospital, School of Medicine, Josip Juraj Strossmayer University, Osijek, Croatia
2 Department of Ophthalmology, Dr. Josip Benčević General Hospital, School of Medicine, Josip Juraj Strossmayer University, Osijek, Croatia
3 Department of Endocrinology, Dr. Josip Benčević General Hospital, School of Medicine, Josip Juraj Strossmayer University, Osijek, Croatia

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.

Klíčová slova: acute coronary syndrome, coronary angiography, 25-hydroxyvitamin D, diabetes, vitamin D deficiency

Vloženo: 30. září 2015; Revidováno: 25. červenec 2016; Zveřejněno: 10. říjen 2017  Zobrazit citaci

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Knežević Praveček M, Vuković-Arar Ž, Miškić B, Hadžibegović I. Vitamin D Deficiency in Acute Coronary Syndrome - Clinically Relevant or Incidental Finding? Cent Eur J Public Health. 2017;25(3):185-190. PubMed PMID: 29022676.
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    Reference

    1. Bikle DD. Vitamin D metabolism, mechanism of action, and clinical applications. Chem Biol. 2014;21(3):319-29. Přejít k původnímu zdroji... Přejít na PubMed...
    2. Ryan JW, Anderson PH, Morris HA. Pleiotropic activities of vitamin D receptors - adequate activation for multiple health outcomes. Clin Biochem Rev. 2015;36(2):53-61. Přejít na PubMed...
    3. Hilger J, Friedel A, Herr R, Rausch T, Roos F, Wahl DA, et al. A systematic review of vitamin D status in populations worldwide. Br J Nutr. 2014;111:23-45. Přejít k původnímu zdroji... Přejít na PubMed...
    4. Zittermann A, Prokop S. The role of vitamin D for cardiovascular disease and overall mortality. Adv Exp Med Biol. 2014;810:106-19. Přejít k původnímu zdroji...
    5. Ross CA, Taylor CL, Yaktine AL, Del Valle HB, editors. Dietary reference intakes for calcium and vitamin D. Washington, DC: The National Academies Press, 2011.
    6. Naesgaard PA, León de la Fuente RA, Nilsen ST, Pönitz V, Brügger-Andersen T, Grundt H, et al. Suggested cut-off values for vitamin D as a risk marker for total and cardiac death in patients with suspected acute coronary syndrome. Front Cardiovasc Med. 2016;3:4. doi: 10.3389/fcvm.2016.00004. Přejít k původnímu zdroji... Přejít na PubMed...
    7. Eren E, Ellidag HY, Yilmaz A, Aydin Ö, Yilmaz N. No association between vitamin D levels and inflammation markers in patients with acute coronary syndrome. Adv Med Sci. 2015;60(1):89-93. Přejít k původnímu zdroji... Přejít na PubMed...
    8. Santoro D, Caccamo D, Lucisano S, Buemi M, Sebekova K, Teta D, et al. Interplay of vitamin D, erythropoiesis, and the renin-angiotensin system. BioMed Res Int. 2015;2015:145828. doi: 10.1155/2015/145828. Přejít k původnímu zdroji... Přejít na PubMed...
    9. Karakas M, Thorand B, Zierer A, Huth C, Meisinger C, Roden M, et al. Low levels of serum 25-hydroxyvitamin D are associated with increased risk of myocardial infarction, especially in women: results from the MONICA/KORA Augsburg case-cohort study. J Clin Endocrinol Metab. 201;98(1):272-80.
    10. Mahdavi K, Amirajam Z, Yazdankhah S, Majidi S, Adel MH, Omidvar B, et al. The prevalence and prognostic role of vitamin D deficiency in patients with acute coronary syndrome: a single centre study in south-west of Iran. Heart Lung Circ. 2013;22(5):346-51. Přejít k původnímu zdroji... Přejít na PubMed...
    11. Ng LL, Sandhu JK, Squire IB, Davies JE, Jones DJ. Vitamin D and prognosis in acute myocardial infarction. Int J Cardiol. 2013;168(3):2341-6. Přejít k původnímu zdroji... Přejít na PubMed...
    12. Belen E, Tipi FF, Aykan AC, Findikçioğlu U, Karakuş G, Yeşil A, et al. Clinical staging in chronic heart failure associated with low vitamin D and elevated parathormone levels. Acta Cardiol. 2014;69(6):665-71. Přejít k původnímu zdroji...
    13. Steg PG, James SK, Atar D, Badano LP, Blömstrom-Lundqvist C, Borger MA, et al. ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. Eur Heart J. 2012;33(20):2569-619. Přejít k původnímu zdroji... Přejít na PubMed...
    14. Hamm CW, Bassand JP, Agewall S, Bax J, Boersma E, Bueno H, et al. ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: the Task Force for the management of acute coronary syndromes (ACS) in patients presenting without persistent ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J. 2011;32(23):2999-3054. Přejít k původnímu zdroji... Přejít na PubMed...
    15. Kim DH, Sabour S, Sagar UN, Adams S, Whellan DJ. Prevalence of hypovitaminosis D in cardiovascular diseases (from the National Health and Nutrition Examination Survey 2001 to 2004). Am J Cardiol. 2008;102(11):1540-4. Přejít k původnímu zdroji... Přejít na PubMed...
    16. Lee JH, Gadi R, Spertus JA, Tang F, O'Keefe JH. Prevalence of vitamin D deficiency in patients with acute myocardial infarction. Am J Cardiol. 2011;107(11):1636-8. Přejít k původnímu zdroji... Přejít na PubMed...
    17. Rodriguez G, Starr AZ, Czernuszewicz GZ, Manhas A, Alhariri A, Willerson JT, et al. Determinants of plasma vitamin D levels in patients with acute coronary syndromes. Eur J Clin Invest. 2011;41(12):1299-309. Přejít k původnímu zdroji... Přejít na PubMed...
    18. Matsuoka LY, Wortsman J, Dannenberg MJ, Hollis BW, Lu Z, Holick MF. Clothing prevents ultraviolet-B radiation-dependent photosynthesis of vitamin D3. J Clin Endocrinol Metab. 1992;75(4):1099-103. Přejít k původnímu zdroji...
    19. Correia LC, Sodré F, Garcia G, Sabino M, Brito M, Kalil F, et al. Relation of severe deficiency of vitamin D to cardiovascular mortality during acute coronary syndromes. Am J Cardiol. 2013;111(3):324-7. Přejít k původnímu zdroji... Přejít na PubMed...
    20. Verdoia M, Schaffer A, Sartori C, Barbieri L, Casseti E, Marino P, et al. Vitamin D deficiency is independently associated with extent of coronary artery disease. Eur J Clin Invest. 2014;44(7):634-42. Přejít k původnímu zdroji... Přejít na PubMed...
    21. Pittas AG, Chung M, Trikalinos T, Mitri J, Brendel M, Patel K, et al. Systematic review: vitamin D and cardiometabolic outcomes. Ann Intern Med. 2010;152(5):307-14. Přejít k původnímu zdroji... Přejít na PubMed...
    22. Alam U, Arul-Devah V, Javed S, Malik RA. Vitamin D and diabetic complications: true or false prophet? Diabetes Ther. 2016;7(1):11-26. Přejít k původnímu zdroji... Přejít na PubMed...
    23. Christodoulidis G, Vittorio TJ, Fudim M, Lerakis S, Kosmas CE. Inflammation in coronary artery disease. Cardiol Rev. 2014;22(6):279-88. Přejít k původnímu zdroji... Přejít na PubMed...
    24. De Metrio M, Milazzo V, Rubin M, Cabiati A, Moltrasio M, Marana I, et al. Vitamin D plasma levels and in-hospital and 1-year outcomes in acute coronary syndromes: a prospective study. Medicine (Baltimore). 2015;94(19):e857. doi: 10.1097/MD.0000000000000857. Přejít k původnímu zdroji... Přejít na PubMed...
    25. Van Orten-Lutein AC, Janse A, Dhonukshe-Rutten RA, Witkamp RF. Vitamin D deficiency as adverse drug reaction: a cross-sectional study in Dutch geriatric outpatients. Eur J Clin Pharmacol. 2016;72(5):605-14. Přejít k původnímu zdroji... Přejít na PubMed...

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