The Effect of Vitamin D Deficiency on the Risk and Time of Stent Restenosis after Percutaneous Coronary Angioplasty: Case-Control Study

Abstract

Objective: Many studies have emphasized the role of inflammation in the development of stent restenosis after percutaneous transluminal coronary angioplasty (PTCA). Vitamin D plays an important role in the modulation of the inflammatory system. Recent studies suggest that vitamin D deficiency is associated with an increased risk of cardiovascular disease. The aim of this study was to investigate the association between vitamin D levels and the development of stent restenosis and the time course of stent restenosis after PTCA. Material and Methods: Fifty-eight patients (Group 1) were consecutively selected among patients admitted to Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital with angina pectoris who developed stent restenosis following PTCA. The control group patients (Group 2) had no stent restenosis following PTCA. Results: The 25(OH) D values were lower in patients with stent restenosis. The difference was significant (11.2 ng/mL vs. 13.8 ng/mL, p=0.02). The risk of restenosis increased 3.4 times when vitamin D level was below 11.3 ng/mL (area under the curve=0.651, 95% confidence interval 0.529-0.773, p=0.02). Also, as time elapsed after PTCA, there was a statistically insignificant weak negative correlation between vitamin D and risk and the time course of stent restenosis (r=-0.181, p=0.219). Conclusion: These findings indicate that lower serum vitamin D levels increase the risk of stent restenosis following coronary interventions. Vitamin D may be a marker for predicting stent restenosis. The already increased risk of restenosis may augment over time as patients' vitamin D levels remain low.