Title: Correlation of Vitamin D level with severity of Coronary Artery Disease(CAD) in patients of Acute Coronary Syndrome(ACS) in a Single Tertiary Care Academic Centre in Eastern India
Authors: Dr (Mrs) Chhabi Satpathy, Dr Nirmal Kumar Mohanty, Dr Bijay Kumar Dash, Prof (Dr) Satyanarayan Routray
DOI: https://dx.doi.org/10.18535/jmscr/v6i5.81
Abstract
Introduction: Now-a-days it is quite clear that there remains an association between cardiovascular disease and Vitamin D deficiency.1 However its prevalence in ACS is unknown. Vitamin-D deficiency seems to predispose to Hypertention, Diabetes Mellitus, Left Ventricular Hypertrophy, Congestive Heart Failure and chronic vascular inflammation.2 Recent evidence has suggested that lower level of Vitamin D is associated with increased all cause and cardiovascular mortality.3
Aims and Objectives: Because Vitamin D deficiency is readily traceable and its supplementation, potentially will be able to improve the outcome of deficient patient, this single tertiary academic centre study is conducted to find out the relation of Vitamin D deficiency with severity of coronary artery disease in patients admitted with acute coronary syndrome.
Materials & Methods: 102 cases of ACS, having estimation of their 25(OH) Vitamin D level following CAG, were included in this study at SCBMC and Hospital Cuttack.
Results: Severe 25(OH) Vitamin D deficiency was found in 6 (5.9%) patients and was associated with almost 2.2 times more triple vessel disease(TVD) and one third times less single vessel disease(SVD) compared to normal or mild to moderate 25(OH) Vitamin D deficient patients. Female patients have significantly lower 25(OH) Vitamin D level compared to the male patients (P<0.001)
Conclusion: Prevalence of 25(OH) Vitamin D level deficiency was high (69.6%) in post ACS setting. Female patients were having statistically significant lower 25(OH) Vitamin D level. (P<0.001) All those with severe deficiency are 2.2 times more likely to develop TVD compared to normal and mild to moderate deficient patients.
Keywords: Coronary Artery Disease,Acute coronary syndrome, 25(OH) Vit.D.
References
- Lee JH et al, Vitamin D deficiency an important, common and easily treatable cardiovascularriskfactor.J.Am.Coll.Cardiol.2008, 52: 1949-1956.
- Geleijnse JM et al, Vitamin D and the prevention of HT & Cardiovascular disease : a review of the current evidence. Am J Hypertens. 2011; 24 : 253 – 262.
- Holick MF et al, Vitamin D deficiency. New Eng J Med. 2007; 357: 266.
- Rashid G et al, Parathyroid hormone stimulates endothelial expression of vascular endothelial growth factor. Eur J Clin Invest. 2008; 38: 798-803.
- Judd SE et al, Vitamin D deficiency and risk for cardiovascular disease. Am J Med Sci. 2009; 338: 40-44.
- Goswami R et al, Presence of 25(OH) D deficiency in a rural North Indian village despite abundant sunshine. J. Asso. Physicians India. 2008; 56: 755-757.
- Harinarayan CV et al. Vitamin D Status in Andhra Pradesh : A population based study. Indian J Med Res. 2008; 127: 211-218.
- Matsuoka LY et al. Racial Pigmentation and the cutaneous synthesis of Vitamin D. Arch Dermatol. 1991; 127: 536-538.
- Syal Sk et al. Vitamin D deficiency, coronary artery disease and endothelial dysfunction : observations from a coronary angiographic study in Indian patients. J Invasive Cardiol. 2012; 24: 385-389.