Correlation Between Plasma 25-Hydroxyvitamin D Level With Angiographic Findings in Male Stemi Patients

Abstract

BACKGROUND Around 25% of deaths among Indians are attributable to CAD. Mortality from CAD in India has increased by 103% in males and 90% in females from 1985 to 2015. 1 The prevalence of CAD in urban India is about double the rate of rural India and about 4-fold higher than in the USA. 2 Vitamin D deficiency (VDD) has been associated with CVD risk factors such as hypertension 3,4 and diabetes mellitus with markers of subclinical atherosclerosis such as intima-media thickness and coronary calcification as well as cardiovascular events such as myocardial infarction and stroke as well as CHF. 5 Aims and Objectives of this study were to evaluate the 25-OH-D status in male patients with STEMI and to know the correlation between the 25-OH-D level and severity of angiography findings. MATERIALS AND METHODSTotal 177 patients taken as per the inclusion and exclusion criteria mentioned below. We had taken 120 patients in our study group out of which 17 did not agree for angiographic interventions and 20 patients were detected to be having newly diagnosed case of type 2 DM, Hypertension, Alcoholic liver disease, smoking, etc. So they were excluded from the study. 83 patients were in study group. 57 patients were in control group. This study is a case control study. Approval from ethical committee was taken. RESULTSMean age of presentation in the study group is 50.73 yrs. ± 11.73 yrs., range being 24 to 74 yrs.as compared to the mean age group of 49.44 yrs. ± 13.2 yrs., range being 24-74 yrs. (p value > 0.05). Distribution patterns of angiographic findings in the study group are as described above i.e. 18 patients (21.7%) were having single vessel disease, 30 patients (36.1%) were having double vessel diseases and majority of the patients(35 patients) were having triple vessel diseases group i.e. 42.2%. Mean 25-OH-D level found in the TVD group was 9.66±3.60 ng/mL as compared to the SVD group where the level was 21.62±2.34 ng/mL, i.e. significantly lower.one way ANOVA test was applied, f value found to be 103.59, p value<0.0001). Mean 25-OH-D level in the study group with complication was 10.72±2.77 ng/mL i.e. significantly lower as compared to the study group without complication where the mean 25-OH-D was 18.37±4.80 ng/mL (p value being <0.0001). It suggests that those patients with lower 25-OH-D were having more trend towards complications like heart failure, arrhythmia, periprocedural AMI, etc. CONCLUSIONOur findings suggested low plasma 25-OH vitamin D in the STEMI patients when compared to the level in the age matched control group; and the lower the level of plasma 25-OH vitamin D the more severe were the incidences of severe angiography findings as described earlier specially in male patients and more were the incidence of complications. Hypovitaminosis D is another novel prognostic indicator for the severity of the CAD which can be treated aggressively to decrease the morbidity and mortality due to coronary artery disease.