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Mehta A, Chokka D, N. S, Seshu A, R. P, M. MP. Correlation of vitamin D level and severity of coronary artery disease. Biomedicine (Taipei) 2022. [DOI: 10.51248/.v42i5.1911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
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 conducted in Kasturba Hospital. Based on coronary angiogram findings, cases were categorised as having single, double, triple or multi vessel disease. Vitamin D level was quantified into 3 categories: normal (>30ng/ml), insufficient (20-30ng/ml) and deficient (<20ng/ml).
Results: Vitamin D deficiency was statistically significantly and inversely related to the number of vessels involved (multi vessel disease-83.3%, triple vessel disease-80%, double vessel disease-28.6% and single vessel disease-21.7%). The relationship between vitamin D levels and syntax scoring showed a negative correlation (-0.339). Multiple linear regression analysis showed that the severity of CAD was correlated to diabetes and vitamin D deficiency with p-value of 0.014.
Conclusion: Both our results and those of previous studies suggest that vitamin D could have a potential therapeutic effect in CAD.
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Şaylık F, Selçuk M, Akbulut T, Çınar T. The Association between Vitamin D Levels and Thrombus Burden in Patients with ST-Elevation Myocardial Infarction. J Tehran Heart Cent 2022; 17:48-55. [PMID: 36567933 PMCID: PMC9748235 DOI: 10.18502/jthc.v17i2.9835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 01/22/2022] [Indexed: 12/27/2022] Open
Abstract
Background: In current practice, establishing the potential predictors of high thrombus burden (HTB) before primary percutaneous coronary intervention (PCI) is crucial for its management. In this research, we aimed to investigate the association between vitamin D levels and HTB in patients with ST-elevation myocardial infarction (STEMI). Methods: This prospective, observational study was conducted on 257 STEMI patients undergoing primary PCI in Van Education and Research Hospital between March 2020 and March 2021. The thrombus burden grade was determined for each subject. The study population was divided into 2 groups: patients with HTB and those with low thrombus burden (LTB) based on the thrombus burden grade. Demographic, laboratory, and angiographic features were compared between the groups. Results: In total, 154 patients (mean age±SD=63.42±11.53 y, 65.6% male) had HTB and 103 patients had LTB (mean age±SD=61.50±10.23 y, 70.9% male). The patients stratified into the HTB group had lower vitamin D levels than those in the LTB group (8.0 ng/mL vs 17.9 ng/mL, respectively; P<0.001). The patients with HTB and low vitamin D levels had lower post-PCI thrombolysis in myocardial infarction (TIMI) flow, TIMI myocardial perfusion grade, and post-PCI ST resolution. In a multivariable analysis, vitamin D was an independent predictor of HTB among the STEMI patients (OR: 0.76, 95%CI: 0.70-0.82; P<0.001). The ideal value of vitamin D to predict HTB was >17.6 ng/mL with a sensitivity of 81.8% and a specificity of 90.3%. Conclusion: The study results showed that vitamin D levels were an independent predictor of HTB in STEMI patients treated by primary PCI.
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Affiliation(s)
- Faysal Şaylık
- Van Training and Research Hospital, Health Sciences University, Van, Turkey.
| | - Murat Selçuk
- Sultan II. Abdulhamid Han Training and Research Hospital, Health Sciences University, Istanbul, Turkey.
| | - Tayyar Akbulut
- Van Training and Research Hospital, Health Sciences University, Van, Turkey.
| | - Tufan Çınar
- Sultan II. Abdulhamid Han Training and Research Hospital, Health Sciences University, Istanbul, Turkey.,Corresponding Author: Tufan Çınar, Health Sciences University, Sultan II. Abdulhamid Han Training and Research Hospital, Tibbiye Street, 34668, Uskudar, Istanbul, Turkey. Tel: +90 21 65422010. Fax: +90 21 65422020. E-mail: .
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Zhernakova NI, Bunova SS, Agarkov NM, Lebedev DT, Aksenov VV. Vitamin D Deficiency as an Independent Predictor of Myocardial Infarction in the Elderly. ARCHIVES OF RAZI INSTITUTE 2021; 76:1069-1076. [PMID: 35096343 PMCID: PMC8791001 DOI: 10.22092/ari.2021.356047.1766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 09/27/2021] [Indexed: 05/25/2023]
Abstract
Cardiovascular diseases are among the most common causes of disability and death in the world, and the number of patients with this category of diseases is increasing every year. This study aimed to investigate the role of vitamin D and the problems caused by its deficiency on the cardiovascular system. Level of D-(25(OH]D) in blood was studied by enzyme immunoassay in 95 elderly patients with myocardial infarction (MI) (the main group) and 92 elderly patients with no history of MI. The level of lipid metabolism as an indicator was determined using a KoneLab 300 auto-analyzer. Based on the results of this study, it was found that the elderly group without MI had the highest amount of D-(25(OH]D)(24.5±1.2), compared to the elderly group with MI (14.8±1.3). The rates of expressed deficiency, deficiency, and insufficiency in the group of elderly with MI were 53.6±5.1, 23.2±4.4, and 12.6±3.4%, respectively. This experiment has shown that D-(25(OH]D) is involved in lipid metabolism and reduces the accumulation of cholesterol by macrophages. The content of vitamin D in blood plasma was a prognostic predictor of MI, which improved MI in the elderly. Regardless of pathological changes, the deficit level of D-(25(OH]D) should be considered a laboratory predictor of MI in the elderly.
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Affiliation(s)
- N I Zhernakova
- FGAOU VO, Belgorod State National Research University, Belgorod, Russia
| | - S S Bunova
- FGAOU VO, Belgorod State National Research University, Belgorod, Russia
| | - N M Agarkov
- FGAOU VO, Belgorod State National Research University, Belgorod, Russia
| | - D T Lebedev
- FGAOU VO, Belgorod State National Research University, Belgorod, Russia
| | - V V Aksenov
- FGBOU VO, South-West State University, Kursk, Russia
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Nepal R, Karki P, Uraw S, Lamsal M. Prevalence of Vitamin D Deficiency among Patients of Acute Coronary Syndrome in a Tertiary Care Center of Eastern Nepal. JNMA J Nepal Med Assoc 2021; 59:225-230. [PMID: 34506449 PMCID: PMC8369531 DOI: 10.31729/jnma.5166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Indexed: 12/04/2022] Open
Abstract
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%) at 95% Confidence Interval (51.58-77.82) patients of acute coronary syndrome had vitamin D deficiency in our study with 19 (37.3%) having mild deficiency and 14 (27.4%) having moderate deficiency. None of the patients had severe vitamin D deficiency in our study. The mean vitamin D levels were lower in diabetics (23.57±9.28ng/ml) as compared to non-diabetics (31.91±12.50ng/ml), in hypertensive patients (24.36±7.67ng/ml) as compared to non-hypertensive patients (30.97±13.72ng/ml), and in patients with dyslipidemia (22.86±6.44ng/ml) as compared to those without dyslipidemia (37.68±13.15ng/ml). CONCLUSIONS Prevalence of vitamin D deficiency among patients of acute coronary syndrome in our study was comparable to various other homologous international studies.
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Affiliation(s)
- Richa Nepal
- Department of Internal Medicine, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Prahlad Karki
- Department of Internal Medicine, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Surendra Uraw
- Department of Internal Medicine, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Madhab Lamsal
- Department of Biochemistry, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
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Cimmino G, Morello A, Conte S, Pellegrino G, Marra L, Golino P, Cirillo P. Vitamin D inhibits Tissue Factor and CAMs expression in oxidized low-density lipoproteins-treated human endothelial cells by modulating NF-κB pathway. Eur J Pharmacol 2020; 885:173422. [PMID: 32755551 DOI: 10.1016/j.ejphar.2020.173422] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 07/21/2020] [Accepted: 07/24/2020] [Indexed: 12/13/2022]
Abstract
Epidemiologic studies have clearly demonstrated the correlation existing between Vitamin D (Vit. D) deficiency and increased risk of developing cardiovascular disease, suggesting that it might have a protective role in this clinical setting. Although many experimental studies have investigated the molecular mechanisms by which Vit. D might exert these effects, its potential role in protecting against athero-thrombosis is still partially unknown. We have investigated whether Vit. D might exert anti athero-thombotic effects by preventing expression of adhesion molecules (CAMs) and Tissue Factor (TF), molecules involved in atherothrombotic pathophysiology, in oxLDL stimulated endothelial cells (HUVEC). Moreover, we have investigated whether Vit. D effects might be due to the NF-kB modulation. HUVEC cultivated in medium enriched with Vit. D (10 nM) were stimulated with oxLDL (50 μg/ml). TF gene (RT-PCR), protein (Western blot), surface expression (FACS) and procoagulant activity (FXa generation assay) were measured. Similarly, CAMs gene (RT-PCR), surface expression (FACS) and soluble values (ELISA) were measured. NF-kB translocation was also investigated. Vit. D significantly reduced TF gene as well protein expression and procoagulant activity in oxLDL-treated HUVEC. Similar effects were observed for CAMs. These effects were associated with Vit. D modulation of NF-κB pathway. This study, although in vitro, indicate that Vit. D has protective effect on endothelial cells by inhibiting expression of TF and CAMs, proteins involved in atherothrombotic pathophysiology. Further studies will be necessary to translate these findings to a clinical scenario to better define the potential therapeutical role of Vit. D supplementation in the management of cardiovascular disease in patients with Vit. D deficiency.
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Affiliation(s)
- Giovanni Cimmino
- Department of Translational Medical Sciences, Section of Cardiology, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Andrea Morello
- Department of Advanced Biomedical Sciences, Section of Cardiology, University of Naples "Federico II", Naples, Italy
| | - Stefano Conte
- Department of Translational Medical Sciences, Section of Cardiology, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Grazia Pellegrino
- Department of Advanced Biomedical Sciences, Section of Cardiology, University of Naples "Federico II", Naples, Italy
| | - Laura Marra
- SC Cell Biology and Biotherapy, Istituto Nazionale Tumori IRCCS, Fondazione G. Pascale, Naples, Italy
| | - Paolo Golino
- Department of Translational Medical Sciences, Section of Cardiology, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Plinio Cirillo
- Department of Advanced Biomedical Sciences, Section of Cardiology, University of Naples "Federico II", Naples, Italy.
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Marquina C, Mousa A, Scragg R, de Courten B. Vitamin D and cardiometabolic disorders: a review of current evidence, genetic determinants and pathomechanisms. Obes Rev 2019; 20:262-277. [PMID: 30450683 DOI: 10.1111/obr.12793] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 09/13/2018] [Accepted: 09/20/2018] [Indexed: 12/14/2022]
Abstract
Vitamin D deficiency has been implicated in the pathophysiology of cardiometabolic disorders including obesity, type 2 diabetes mellitus, cardiovascular diseases and polycystic ovary syndrome. Despite a large number of experimental and observational studies supporting a role for vitamin D in these pathologies, randomized controlled trials have reported little to no effect of vitamin D supplementation in the prevention or treatment of these disorders, although some results remain ambiguous. Polymorphisms in genes related to vitamin D metabolism, particularly in the vitamin D receptor and binding protein and the metabolizing enzyme 1-α-hydroxylase, have emerged as potential contributors to these divergent results. It is now becoming increasingly recognized that the effects and potential benefits of vitamin D supplementation may vary by several factors including vitamin D deficiency status, ethnicity and/or the presence of genetic variants, which affect individual responses to supplementation. However, these factors have seldom been explored in the available literature. Future trials should consider inter-individual differences and, in particular, should aim to clarify whether certain subgroups of individuals may benefit from vitamin D supplementation in the context of cardiometabolic health.
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Affiliation(s)
- C Marquina
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - A Mousa
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - R Scragg
- School of Population Health, The University of Auckland, Auckland, New Zealand
| | - B de Courten
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
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Serum Vitamin D Level in Patients with Coronary Artery Disease and Association with Sun Exposure: Experience from a Tertiary Care, Teaching Hospital in India. Adv Med 2019; 2019:6823417. [PMID: 30863784 PMCID: PMC6378067 DOI: 10.1155/2019/6823417] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 11/05/2018] [Accepted: 12/10/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Vitamin D, a fat-soluble vitamin, has various extraskeletal effects, and several human and animal studies have suggested that vitamin D deficiency may be a contributory factor in the pathogenesis of coronary artery disease (CAD). However, such studies in the Indian subcontinent are either lacking or have shown conflicting results. METHODS This was a descriptive cross-sectional study involving 121 patients with CAD from a tertiary care center and their 80 age-matched healthy controls. Serum vitamin D levels along with serum and urine chemistries were measured in both the groups. The average duration of sun exposure/day and use of sunscreen were also considered in the study cohort using a questionnaire. Serum vitamin D levels were categorized into deficient (<30 nmol/lit), insufficient (30-75 nmol/lit), and sufficient (>75 nmol/lit) groups. RESULTS Among the cases, 51.2% of the patients were vitamin D deficient and 44.6% patients had insufficient vitamin D levels, whereas among controls, 40% and 31% of the population had deficient and insufficient levels of vitamin D, respectively. However, the mean value of the serum vitamin D level was not statistically different in the cases as compared to that of the controls (34.06 vs 40.19 nmol/lit) (P=0.08). Corrected serum calcium (9.26 vs 9.59 mg%) (P ≤ 0.0001) and serum albumin levels (4.21 vs 4.75 gm%) (P ≤ 0.0001) were lower in the cases than those of the controls. The average sun exposure/day was higher among the cases than that among the controls (2.93 vs 1.85 hours) (P=0.001). CONCLUSION Vitamin D deficiency is widely prevalent in Indian population despite abundant sunshine, and the duration of sun exposure is not correlated with serum vitamin D levels. Vitamin D deficiency is not associated with CAD. However, serum calcium is deficient in CAD patients as compared to the controls. Large-scale studies are required to explore the association further to evaluate the benefits of screening and correction of vitamin D deficiency in patients with CAD.
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Muscogiuri G, Annweiler C, Duval G, Karras S, Tirabassi G, Salvio G, Balercia G, Kimball S, Kotsa K, Mascitelli L, Bhattoa HP, Colao A. Vitamin D and cardiovascular disease: From atherosclerosis to myocardial infarction and stroke. Int J Cardiol 2016; 230:577-584. [PMID: 28043680 DOI: 10.1016/j.ijcard.2016.12.053] [Citation(s) in RCA: 83] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Revised: 11/14/2016] [Accepted: 12/16/2016] [Indexed: 12/24/2022]
Abstract
There continues to be interest in understanding the role of vitamin D in the pathogenesis, epidemiology and prevention of cardiovascular disease (CVD). In fact vitamin D deficiency has been associated to an increased risk of developing CVD given to the relationship between low vitamin D levels and obesity, diabetes mellitus, dyslipidaemia, endothelial dysfunction and hypertension. However, although vitamin D has been identified as a potentially important marker of CVD, the mechanisms through which vitamin D deficiency leads from endothelial dysfunction to myocardial infarction and stroke are not fully understood. Thus, the goal of this review is to provide an updated review of the literature on the basic science of how vitamin D may affect the cardiovascular system and in particular to analyze the role that vitamin D may have in the whole dynamic process from the initiation of endothelial dysfunction to the development of myocardial infarction and stroke.
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Affiliation(s)
| | - Cedric Annweiler
- Department of Neuroscience, Division of Geriatric Medicine, Angers University Hospital, Angers, France; University Memory Clinic, UPRES EA 4638, University of Angers, UNAM, Angers, France; Robarts Research Institute, Department of Medical Biophysics, Schulich School of Medicine and Dentistry, the University of Western Ontario, London, Ontario, Canada
| | - Guillaume Duval
- Department of Neuroscience, Division of Geriatric Medicine, Angers University Hospital, Angers, France
| | - Spyridon Karras
- Department of Internal Medicine, Division of Endocrinology, Diabetes and Metabolism, AHEPA Hospital, Thessaloniki, Greece
| | - Giacomo Tirabassi
- Division of Endocrinology, Department of Clinical and Molecular Sciences, Umberto I Hospital, Polytechnic University of Marche, Ancona, Italy
| | - Gianmaria Salvio
- Division of Endocrinology, Department of Clinical and Molecular Sciences, Umberto I Hospital, Polytechnic University of Marche, Ancona, Italy
| | - Giancarlo Balercia
- Division of Endocrinology, Department of Clinical and Molecular Sciences, Umberto I Hospital, Polytechnic University of Marche, Ancona, Italy
| | | | - Kalliopi Kotsa
- Department of Internal Medicine, Division of Endocrinology, Diabetes and Metabolism, AHEPA Hospital, Thessaloniki, Greece
| | - Luca Mascitelli
- Comando Brigata alpina "Julia"/Multinational Land Force, Medical Service, Udine, Italy
| | - Harjit Pal Bhattoa
- Department of Laboratory Medicine, Endocrinology Unit, Faculty of Medicine, University of Debrecen, Hungary
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Pérez-Hernández N, Aptilon-Duque G, Nostroza-Hernández MC, Vargas-Alarcón G, Rodríguez-Pérez JM, Blachman-Braun R. Vitamin D and its effects on cardiovascular diseases: a comprehensive review. Korean J Intern Med 2016; 31:1018-1029. [PMID: 27117316 PMCID: PMC5094929 DOI: 10.3904/kjim.2015.224] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Accepted: 10/10/2015] [Indexed: 12/15/2022] Open
Abstract
Vitamin D is a molecule that is actively involved in multiple metabolic pathways. It is mostly known for its implications related to calcium metabolism. It has also been determined that it actively participates in the cardiovascular system, influencing blood pressure, coronary artery disease and other vascular diseases, such as heart failure and atrial fibrillation. Furthermore, it has been established that this vitamin is extensively involved in the regulation of both the renin angiotensin aldosterone system and the immune system. In this review, we present the different vitamin D metabolic pathways associated with the cardiovascular pathophysiology, and we include studies in animal and human models, as well as some of the controversies found in the literature. This review also incorporates an overview of the implications in the molecular biology and public health fields.
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Affiliation(s)
- Nonanzit Pérez-Hernández
- Department of Molecular Biology, National Institute of Cardiology “Ignacio Chavez”, Mexico City, Mexico
- Nonanzit Pérez-Hernández, Ph.D. Department of Molecular Biology, National Institute of Cardiology “Ignacio Chavez”, Juan Badiano No. 1, Col. Sección XVI, Tlalpan 14080, Mexico City, Mexico Tel: +52-55-55732911 Fax: +52-55-551365811 E-mail:
| | - Gad Aptilon-Duque
- Department of Molecular Biology, National Institute of Cardiology “Ignacio Chavez”, Mexico City, Mexico
- Faculty of Health Sciences, Anahuac University, Huixquilucan, Mexico
| | | | - Gilberto Vargas-Alarcón
- Department of Molecular Biology, National Institute of Cardiology “Ignacio Chavez”, Mexico City, Mexico
| | | | - Ruben Blachman-Braun
- Department of Molecular Biology, National Institute of Cardiology “Ignacio Chavez”, Mexico City, Mexico
- Faculty of Health Sciences, Anahuac University, Huixquilucan, Mexico
- Correspondence to Ruben Blachman-Braun, M.D. Department of Molecular Biology, National Institute of Cardiology “Ignacio Chavez”, Juan Badiano No. 1, Col. Sección XVI, Tlalpan 14080, Mexico City, Mexico Tel: +52-55-55732911 Fax: +52-55-551365811 E-mail:
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