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Vitamin D deficiency is independently associated with the extent of coronary artery disease.
MedLine Citation:
PMID:  24829065     Owner:  NLM     Status:  Publisher    
BACKGROUND: Vitamin D (25-OH D3) deficiency represents a rising social and economic problem in Western countries. Vitamin D has been recently reported to modulate inflammatory processes, endothelium and smooth muscle cell proliferation and even platelet function, thus potentially modulating atherothrombosis. Great interest has been addressed on its impact on cardiovascular outcome, with contrasting results. The aim of current study was to evaluate the relationship between 25-OH D3 and the extent of coronary artery disease in a consecutive cohort of patients undergoing coronary angiography.
METHODS: Patients undergoing elective coronary angiography were included in a cross-sectional study. Fasting samples were collected for 25-OH D3 levels assessment. Significant CAD was defined as at least 1 vessel stenosis > 50%, while severe CAD as left main and/or trivessel disease, as evaluated by Quantitative Coronary Angiography.
RESULTS: Hypovitaminosis D was observed in 70.4% out of 1484 patients. Patients were divided according to vitamin D tertiles (<9.6; 9.6-18.4; >18.4). Lower vitamin D levels were associated with age, female gender (p<0.001, respectively), renal failure (p=0.05), active smoking (p=0.001), acute coronary syndrome at presentation (p<0.001), therapy with calcium-antagonists (p=0.02) and diuretics (p<0.001), less beta-blockers (p=0.02) and statins (p=0.001) use. Vitamin D directly related to haemoglobin (p<0.001) and inversely with platelet count (p=0.002), total and LDL cholesterol (p=0.002 and p<0.001) and triglycerides (p=0.01). Vitamin D did not influence angiographic features of coronary lesions, but was associated with higher prevalence of left main or right coronary artery disease (p=0.03). Vitamin D deficiency was significantly associated with higher prevalence of CAD (adjusted OR[95%CI]=1.32[1.1-1.6],p=0.004) and severe CAD (adjusted OR[95%CI]= 1.18[1-1.39], p=0.05).
CONCLUSION: In patients undergoing coronary angiography hypovitaminosis D was observed in the vast majority of patients. Vitamin D deficiency is significantly associated with the prevalence and extent of CAD, especially for patients with values < 10 ng/ml. Therefore, future large studies are needed to evaluate whether vitamin D supplementation may prevent CAD and its progression. This article is protected by copyright. All rights reserved.
Monica Verdoia; Alon Schaffer; Chiara Sartori; Lucia Barbieri; Ettore Cassetti; Paolo Marino; Gennaro Galasso; Giuseppe De Luca;
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-5-14
Journal Detail:
Title:  European journal of clinical investigation     Volume:  -     ISSN:  1365-2362     ISO Abbreviation:  Eur. J. Clin. Invest.     Publication Date:  2014 May 
Date Detail:
Created Date:  2014-5-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0245331     Medline TA:  Eur J Clin Invest     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
This article is protected by copyright. All rights reserved.
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