Saudi Arabia: A recent study published in the journal Vascular Health and Risk Management found a strong association between vitamin D and its metabolites with acute coronary syndrome (ACS). However, the researchers add that there is a need for large randomized controlled trials to verify beneficial values of vitamin D supplementation in patients with ACS.
According to the study, vitamin D and all its metabolites were significantly deficient in all ACS patients compared to controls. In addition, the researchers demonstrated that 25(OH)D, 1,25(OH)2D, total cholesterol, low HDL-C, and high systolic BP were statistically significant ACS predictors. There was no association between the number of affected coronary vessels and vitamin D and its metabolites.
Vitamin D deficiency is an emerging health problem and affects about one billion patients worldwide. Calcitriol 1,25(OH)2D3 has several systemic effects, including anti-thrombotic, anti-inflammatory, and anti-atherosclerotic impacts that explain its cardioprotective effects. However, there is still a controversy on the precise association between vitamin D and its metabolites and the value of supplements in ACS.
Considering the above, Hussein M Ismail, Department of Cardiology, College of Medicine, Suez Canal University, Ismailia, Egypt, and colleagues aimed to search the association between vitamin D2, D3, and metabolites and ACS in patients undergoing coronary angiography in a case-control study.
The study included 73 consecutive adult patients with ACS undergoing coronary angiography and compared to 50 controls without coronary artery disease. They were matched for age and sex from June 2019 till July 2019. For all cases, echocardiography and coronary angiography were performed. Plasma vitamin D and its metabolites were measured at admission for all participants along with chemistry profiles.
The study yielded the following findings:
Vitamin D and its metabolites were statistically significantly lower in ACS patients than the controls.
Multivariate regression analysis revealed that low levels of 25-hydroxyvitamin D (25(OH)D) and 1,25-dihydroxyvitamin D (1,25(OH)2D) significantly predicted ACS occurrence; the other significant predictors were high systolic blood pressure (BP), high total cholesterol, and low high-density lipoprotein-cholesterol. Interestingly, vitamin D2 and D3 did not significantly predict ACS.
The researchers did not find a statistically significant association between the number of affected coronary vessels and vitamin D metabolites.
There was no statistically significant correlation between vitamin D and its metabolites and left ventricular ejection fraction measured by echocardiography.
"There was a strong association between vitamin D and all its metabolites with ACS. Significantly, low 25(OH)D and 1,25(OH)2D predicted ACS, but vitamin D2 and D3 did not," wrote the authors. "Large randomized controlled trials are needed to verify the beneficial values of vitamin D supplementation in ACS patients."
Reference:
The study titled, "Vitamin D and Its Metabolites Deficiency in Acute Coronary Syndrome Patients Undergoing Coronary Angiography: A Case–Control Study," is published in the journal Vascular Health and Risk Management (from Dovepress).
DOI: https://www.dovepress.com/vitamin-d-and-its-metabolites-deficiency-in-acute-coronary-syndrome-pa-peer-reviewed-fulltext-article-VHRM