To evaluate the role of plasma vitamin D level as a prognostic marker and its relation to in-hospital complications in patients with acute coronary syndrome

Abstract

Background: Deficiency in 25-hydroxyvitamin D (25[OH] D), the main circulating form of vitamin D in blood, could be involved in the pathogenesis of acute coronary syndromes (ACS). To date, however, the possible prognostic relevance of 25 (OH) D deficiency in ACS patients remains poorly defined. The purpose of this study was to assess the association between 25 (OH) D levels, at hospital admission, with in-hospital complications in an unselected cohort of ACS patients. Methods: We measured 25 (OH) D in 200 ACS patients at hospital presentation. Vitamin D serum levels >30  ng/mL were considered as normal; levels between 29 and 21  ng/mL were classified as insufficiency, and levels  < 20  ng/mL as deficiency. In-hospital complications were evaluated according to 25 (OH) D levels. Results: In the study population 85(42.5%) patients had normal 25 (OH) D levels, whereas 36 (18%) and 79 (39.5%) had vitamin D insufficiency and deficiency, respectively. The patients with vitamin D deficiency were associated with a higher risk for several in-hospital MACEs (major adverse clinical events) including mortality and it was statistically significant (P value < 0.05).  The left ventricular function was more severely compromised in patients with vitamin D deficiency and it was statistically significant (P value < 0.05). Conclusions: In ACS patients, severe vitamin D deficiency is independently associated with poor in-hospital outcomes. Whether low vitamin D levels represent a risk marker or a risk factor in ACS remains to be elucidated.