Vitamin D insufficiency is associated with coronary artery tortuosity

Abstract

A b s t r a c tBackground: Increasing evidence suggests a relationship between vitamin D (VD) insufficiency and cardiovascular disease. Aim:We aimed to investigate the association between serum 25-hydroxyvitamin D (25-OH VD) with coronary tortuosity (CT) in patients with normal or near-normal (< 40% stenosis) coronary arteries. Methods:The present study was cross-sectional and observational. We enrolled 356 consecutive patients who had undergone coronary angiography for suspected ischaemic heart disease and were found to have normal or near-normal coronary arteries. Patients were categorised as VD insufficient (< 30 ng/mL) or VD sufficient (≥ 30 ng/dL). CT was defined as the presence of ≥ three bends (defined as ≥ 45° change in vessel direction) along the main trunk of at least one coronary artery, present both in systole and in diastole. Results:The study populations were divided into two groups according to the presence of CT: patients with CT (n = 103, 29%) and patients without CT (NCT; n = 253, 71%). CT is more frequently seen in elderly women and is positively correlated with hypertension. The incidence of VD insufficiency was significantly higher in the CT group (n = 46, 45%) than in the NCT group (n = 90, 36%; p = 0.005). In further multivariate logistic regression analyses, adjustment for major clinical parameters affecting CT showed statistically significant correlations between 25-OH VD and CT (odds ratio = 0.77, 95% confidence interval 0.66-0.98, p = 0.006). Conclusions: Vitamin D insufficiency was independently associated with coronary tortuosity.Key words: vitamin D insufficiency, coronary tortuosity, coronary artery disease, biomarkers, coronary angiography Kardiol Pol 2017; 75, 2: 174-180 INTRODUCTIONCoronary artery disease (CAD) is the leading cause of mortality and morbidity worldwide. Coronary angiography is still the gold standard for the diagnosis of CAD, and coronary artery tortuosity (CT) is a common coronary angiography (CAG) finding [1][2][3]. The aetiology and clinical importance of CT are still unclear. CT is generally attributed to age-dependent, pathologic changes of elastic material in the vessel, and hypertension due to elongation and dilatation of the arteries with left ventricular hypertrophy [3,4]. A recent clinical trial showed that CT was associated with subclinical atherosclerosis and increased coronary artery calcification, even in the absence of significant obstructive lesion [5].

Evaluation of vitamin D levels in relation to coronary CT angiographic findings in an Iranian population

“…Several studies have been performed on the association between vitamin D status and different aspects of cardiovascular disorders, including metabolic syndrome,9 hypertension,10,11 calcified atherosclerotic plaques,12,13 severity of luminal stenosis in coronary arteries,14,15 tortuosity of coronary arteries,16 and even the final outcomes or lethal events of coronary artery disease (CAD) 17. In this regard, the need for increased attention has been proposed, suggesting the role of vitamin D deficiency as a risk factor for CAD.…”

Association between vitamin D levels and arterial hypertension in women at very high cardiovascular risk

“…Some trials showed connection between 25(OH)D serum level and blood pressure (BP), and some didn't. Moreover, other trials showed that vitamin D levels are associated with development and course of not only HTN but also other CVDs including coronary heart disease and heart failure [9][10][11][12].…”