Correlation of Vitamin D level with severity of Coronary Artery Disease(CAD) in patients of Acute Coronary Syndrome(ACS) in a Tertiary Care Centre in Western India (original) (raw)
Related papers
Vitamin D Deficiency in Acute Coronary Syndrome: A Study in Govt. Royapettah Hospital
Journal of Evolution of Medical and Dental Sciences, 2016
BACKGROUND Vitamin D deficiency has been linked to an increased risk of coronary artery disease and cardiovascular death. Vitamin D deficiency promotes endothelial dysfunction, which plays a vital role in the pathogenesis of coronary artery disease. AIMS AND OBJECTIVES 1. To assess vitamin D levels and study the correlation of Vitamin D deficiency with acute coronary syndrome. 2. To analyse the vitamin D status of the study population. METHODS Serum 25 (OH) vitamin D levels were measured in 50 cases of Acute Myocardial Infarction and 50 matched controls. The association of vitamin D deficiency with other parameters such as age, gender, body mass index, lipid profile, serum albumin, and calcium were also analysed. RESULTS 64% of the cases were deficient in Vitamin D (<15 ng/mL) and 36% of the cases had insufficient levels (15-30 ng/mL). The mean vitamin D level among the cases was 13.5 ng/mL and that among the controls was 24.3 ng/mL and this was indicative of a statistically significant difference. In the 100 subjects, 45% were deficient and 43% had insufficient levels. 70% of the patients with vitamin D deficiency had BMI > 25 kg/m 2. CONCLUSION Vitamin D deficiency may be an independent and potentially modifiable cardiovascular risk factor that can be easily diagnosed and corrected. The treatment is safe and cost effective. Hence, general awareness needs to be created on the early detection and management of this risk factor and guidelines need to be implemented.
Journal of Evolution of Medical and Dental Sciences
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 remain poorly defined. The purpose of this prospective study was to assess the association between 25 (OH) D levels in ACS. MATERIALS AND METHODS Total 100 cases were studied in Krishna Institutes of Medical Sciences, Karad. All adult age > 18 years admitted for acute coronary syndrome were eligible for this study. We measured 25 (OH) D in 100 ACS patients at hospital presentation; 74% of them were above the age of 50 years at the time of presentation. The ACS group was studied as STEMI, NSTEMI and unstable angina; 62% of whom were admitted with STEMI, 20% NSTEMI and the remaining 18% with unstable angina. Vitamin D serum levels > 30 ng/mL were considered as normal; levels between 30 and 21 ng/mL were classified as insufficiency and levels < 20 ng/mL as deficiency. RESULTS In the current study, the percentage of Vitamin D deficiency individuals among the study population amounted to 46% and Vitamin D insufficiency 33%. No correlation was evident between vitamin D level, age and sex. CONCLUSION Vitamin D deficiency and insufficiency were common in patients with acute coronary syndrome patients.
Correlation of vitamin D level and severity of coronary artery disease
Biomedicine
Introduction and Aim: Cardiovascular diseases are the leading cause of death worldwide. The prevalence of cardiovascular disease in India is continuously on the rise owing to the socioeconomic changes the country is undergoing. In order to minimise the mortality due to cardiovascular disease, early detection and control of modifiable risk factors is of utmost importance. We evaluated the correlation of vitamin D deficiency, one such possible modifiable risk factor, and the severity of CAD in patients at a hospital in Southern Karnataka. Unfortunately, relevant data regarding vitamin D deficiency in coronary artery disease pertaining to the Indian subcontinent is scarce. Thus, the results of our study can provide further evidence for the potential therapeutic benefit of Vitamin D in patients with cardiovascular risk factors, which in the long run can significantly reduce the morbidity and mortality of CAD. Materials and Methods: A case-control study with 142 subjects was conducte...
Association of Vitamin D Deficiency with Coronary Artery Disease
JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2016
The World Health Organization estimated a rise in mortality from Cardiovascular Diseases (CVD) from 17.1 million in 2004 to 23.4 million in 2030 [1]. CAD and hypertension are major contributors to this global health problem. There are multiple risk factors for CAD in addition to hypertension. It is therefore important to find out newer preventable, modifiable risk factors for CAD and hypertension to decrease mortality and morbidity related to CVD. The role of vitamin D is well known in calcium and phosphate metabolism which facilitates bone mineralization, muscle contraction, nerve conduction and general cellular function [2,3]. In past two decades, the role of vitamin D has extended to immune modulation, cell differentiation, modulation of transcription of cell cycle proteins of osteoclastic precursors, enterocytes, keratinocytes and now it is used for the treatment of psoriasis also [4-6]. Recent studies demonstrated that lower vitamin D level (< 30ng/ ml) is associated with higher blood pressure [7] and directly or indirectly with CAD, may be due to vascular endothelial damage [8,9]. One study also demonstrated the blood pressure lowering effect of vitamin D [10]. But all the study results are conflicting and inconsistent towards same direction [11,12]. Most of these studies were done on western population where prevalence of vitamin D deficiency is very high [13,14]. The prevalence of vitamin D deficiency (<30ng/ml) is also very high in Southeast Asia and India [15-17]. But there is lack of study regarding association of vitamin D deficiency with CAD, comparing the vitamin D level between angiography proven CAD and normal coronary artery. MAtErIALS And MEtHOdS Study Design and Study Population: It was a cross-sectional observational study. A total of 315 patients were selected consecutively and underwent coronary angiography as per ACC/ AHC guideline [18] in Post Graduate Institute of Medical Education and Research (PGIMER) at Chandigarh, India, a tertiary care centre in Northern India, during the period of March 2012 to May 2012. Patients were recruited as per medical ethics and informed consent was taken from each participant. Patients with 30-70 years of age, irrespective of gender were included in the study. Patients who were haemodynamically unstable, in shock or heart failure were excluded. Patients, who were already taking vitamin D, had known cardiac disease, chronic kidney disease, liver disease, hypo or hyperparathyroidism, pregnancy, evidence of infection and fever were also excluded from the study. Patients with anaemia (serum haemoglobin level <13g/dl for male and <12g/dl for female) were also excluded as low haemoglobin is associated with increased risk and greater severity of CAD [19,20]. MAtErIALS And MEtHOdS Detailed history was taken and age, sex, BMI, blood pressure were documented. Complete blood count, renal function test and lipid profile of all the patients were done in the institute laboratory by standard methods. CAD was defined as patients with angiography proven stenosis of ≥50% in one or more major coronary arteries [21]. These major arteries are left anterior descending artery, left main, left circumflex artery and right coronary artery with right dominant, balanced, or left dominant circulation. The angiography findings was reported as normal coronary artery, insignificant CAD, significant CAD with severity for coronary artery stenosis in the form of 50% to 100% or complete cutoff. In this study angiographic normal and insignificant CAD were included in the normal coronary artery group. The maximum severity of stenosis was considered as final. The severity of stenosis was graded as 50%-70%, >70%-90% and >90%. The number of vessels involved were analysed separately.
2021
Introduction: Vitamin D deficiency is an emerging risk factor for cardiovascular diseases. Very few studies have been done to find out vitamin D deficiency status among cardiovascular patients in Nepalese setup. This research aims to find out the prevalence of vitamin D deficiency among patients of acute coronary syndrome admitted in a tertiary care center of eastern Nepal. Methods: This was a descriptive cross-sectional study conducted among patients of acute coronary syndrome admitted in a tertiary care hospital from 1st February 2018 to 31st July 2018. Ethical clearence was taken from Institutional Review Committee of B.P. Koirala Institute of Health Sciences (Reference number: 259/074/075-IRC). Convenience sampling method was used. Data was entered in Microsoft Excel and analyzed using Statistical Package for the Social Sciences version 25. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: A total of 33 (64.7%)...
2020
Introduction: vitamin D affects the function of most of the cells in the body, including myocytes and endothelial cells, and also affects platelet function. This study aims to evaluate the relation between vitamin D deficiency and in-hospital and 6-month outcomes of patients with the acute coronary syndrome.Methods: This was a prospective cohort study of patients admitted to Mousavi hospital with the diagnosis of acute coronary syndrome. A venous blood sample obtained from patients at the time of admission and 25-hydroxyvitamin D, lipid profile, and hs-troponin-I levels were measured. After coronary angiography, the severity of the coronary artery stenosis was calculated by the syntax score. Patients also evaluated in-hospital outcomes and even followed up for 6-month results.Results: Totally, 204 patients were included in the study. The mean ± SD of age was 60 ± 11.6-year-old. The overall vitamin D deficiency was 80.9%. There was no association between vitamin D deficiency and in-h...
2014
Material and Method: Sixty five ACS cases (37 males and 28 females) over 18 years old, and 40 controls (20 males and 20 females) with an age and gender distribution similar to the patient group and with no systemic diseases took part in the study. Serum 25-hidroxy-vitamin D level has been clinically described as severe deficiency for <10 ng/ml, deficiency for 10-20 ng/ml, failure for 20-30 ng/ml, and normal for >30 ng/ml based on serum 25-hydroxy-vitamin D levels. Results: The vitamin D levels of patients in the ACS were found to be significantly lower than the control group. Vitamin D failure distribution differs (p<0.05) in the case group and control group. Severe failure and failure rates were higher in the case group. Severe vitamin D failure was found in 27 (41.5%) patients with ACS, vitamin D failure was found in 24 (36%) patients. Three early mortality cases were seen in the ACS patients.
Archives of Medical Science
Introduction: Ischaemic heart disease is the main cause of death in developed countries. There are many modifiable risk factors associated with coronary heart disease (CAD). A growing number of studies point to vitamin D deficiency as a risk factor for heart attacks and the conditions associated with cardiovascular disease. This study aimed to analyse the relationship between the level of 25-hydroxyvitamin D (25(OH)D) and the severity of coronary artery atherosclerosis and to study 25(OH)D levels in non-diabetic patients hospitalised due to acute coronary syndrome and those diagnosed with stable CAD. Material and methods: Coronary angiography was performed prospectively in 410 successive cardiac patients. The severity of coronary artery atherosclerosis was assessed according to the Coronary Artery Surgery Study Score (CASSS). The plasma 25(OH)D level was assessed with the electrochemiluminescence method. Results: The 25(OH)D level proved to be one of the significant determinants of the CASSS (p < 0.05). In subjects without significant lesions in the coronary arteries the 25(OH)D level was significantly higher compared to patients with one-to three-vessel coronary atherosclerosis (p < 0.05). A significantly higher 25(OH)D level was noted in patients diagnosed with stable CAD compared to patients hospitalised due to acute coronary syndrome (p < 0.01). Conclusions: Patients with one-to three-vessel atherosclerosis have a significantly lower 25(OH)D level compared to patients without significant lesions in the coronary arteries. A lower 25(OH)D level was observed in patients hospitalised due to acute coronary syndrome compared to patients diagnosed with stable CAD.
Assessment of Vitamin D Levels in Patients with Acute Coronary Syndrome and Its Risk Factors
Scholars Journal of Applied Medical Sciences, 2020
Original Research Article Background: Conventional risk factors for acute coronary syndrome (ACS) have failed to explain highly variable prevalence of ACS among different races. Growing body of evidence has identified vitamin D (25OHD) deficiency as a potential risk factor for ACS. Objectives: 1) To determine the relationship between vitamin D level and ACS 2) To analyze vitamin D level with other risk factors of ACS. Material and methods: 100 patients diagnosed as ACS. Serum 25OHD concentrations were analyzed, and risk factors for ACS were evaluated. Results: Out of 100 patients diagnosed as ACS. 25OHD was deficient in 40 patients and insufficient in 54 patients and was normal in only 6 patients. Out of the total 63 Diabetic patients, 32 were 25OHD deficient and 31 were insufficient. Out of 76 Hypertensive patients, 33 were 25OHD deficient and 40 were insufficient and four patients had normal levels. Of the 13 patients who didn't had either of risk factor 25OHD deficiency was seen in 5 patients and insufficiency in 5 patients and normal level in 2 patients. Conclusion: In the current study we observed a significant deficiency of vitamin D in patients with acute coronary syndrome and its risk factors. Since Vitamin D deficiency is a potentially modifiable risk factor, patients getting admitted with acute coronary syndrome should be screened and treated accordingly.