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Category: Volume 06 Issue 02 February 2018
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Title: A Study of Vitamin D Levels in Patients with Acute Myocardial Infarction in a Tertiary Care Hospital in Western India

Authors: Vivek Gupta, Ranjita Bansal, Milind Shrivastava, Atul Kasliwal

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i2.85

Abstract

Introduction: Either independently or in association with other factors low vitamin D is one of risk factors in coronary atherosclerosis athough the causal relationship is not yet established.

Aim & Objective: To study the prevalence of vitamin D deficiency in patients with acute myocardial infarction  and to study  if  any association exists between them.

Materials & Methods: Hundred cases of acute myocardial infarction (MI) and hundred healthy controls were included in this study. The study was conducted at SDM hospital Cum Medical Research Institute, Jaipur during November 2015 to October 2016. Biochemical and clinical risk factors assessed for MI .Serum 25 (OH) vitamin D levels measured using radioimmunoassay.

Results: Severe vitamin D deficiency (25(OH) vitamin D less than 10 ng/ml) found in 67% of cases and 48% of controls. Vitamin D deficiency (25(OH) vitamin D 10_<30 ng/ml) found in 24% of cases and 34% of controls. Sufficient vitamin D ( 25(OH) vitamin D >30 ng/ml) found  in 9% of cases and 18% of controls. Risk of Myocardial infarction in patients with severe vitamin D deficiency associated with an odds ratio of 2.19 (95% CI 1.1-4.9) (statistically significant p<0.05).

Conclusions: High prevalence of vitamin D deficiency was found among patients of acute Myocardial Infarction and controls. 25 (OH) vitamin D was significantly lower in cases as compared to controls. Even after considering for conventional risk factors for myocardial infarction severe vitamin D deficiency was associated with risk of acute myocardial infarction.

Keywords: Myocardial Infarction, Vitamin D Level, Atherosclerosis.

References

  1. Geleijnse JM. Vitamin D and the prevention of hypertension and cardiovascular diseases: a review of the current evidence. Am J Hypertens. 2011;24:253-262.
  2. Grandi NC, Breitling LP, Brenner H. Vitamin D and cardiovascular disease: systematic review and meta-analysis of prospective studies. Prev Med. 2010;51:228-233.
  3. Rashid G, Bernheim J, Green J, Benchetrit S. Parathyroid hormone stimulatesthe endothelial expression of vascular endothelial growth factor. Eur J Clin Invest. 2008;38:798-803.
  4. Zittermann A, Schleithoff SS, Koerfer R. Putting cardiovascular disease and vitamin D insufficiency into perspective. Br J Nutr. 2005;94:483-492.
  5. Milani RV, Lavie CJ, Mehra MR. Left ventricular geometry and survival in patients with normal left ventricular ejection fraction. Am J Cardiol. 2006;97:959-963.24.
  6. Penckofer S, Kouba J, Wallis DE, Emanuele MA. Vitamin D anddiabetes: let the sunshine in. Diabetes Educ. 2008;34:939-940, 942,.
  7. Pittas AG, Lau J, Hu FB, Dawson-Hughes B. The role of vitamin D and calcium in type 2 diabetes. A systematic review and meta-analysis. J Clin Endocrinol Metab. 2007;92:2017-2029.
  8. Judd SE, Tangpricha V. Vitamin D deficiency and risk for cardiovascular disease. Am J Med Sci. 2009;338:40-44.
  9. O'Connell TD, Berry JE, Jarvis AK. 1,25-DihydroxyvitaminD 3 regulation of cardiac myocyte roliferation and hypertrophy. Am J Physiol. 1997;272:H1751-H1758.
  10. Thygeson K, Alpert JS, Jaffe AS. Third universal definition of myocardial defin-ition. J.Am.Coll.Cardiol 60(2012);1581
  11. Bonaca MP, Wiviott SD, Braunwald E. American College Of Cardiology, American Heart Association, Europian Society Of Cardiology, World Heart Federation, Universal definition of myocardial infarction,classification system and the risk of cardiovascular death,Observation from the TRITON-TIMI 38 trial,Circulation 125(2012);577
  12. Scragg R, Sowers M, Bell C. Serum 25-hydroxyvitamin D, diabetes, and ethnicity in the Third National Health and Nutrition Examination Survey. Diabetes Care 2004;27:2813– 8.
  13. Riachy R, Vandewalle B, Moerman E. 1,25-Dihydroxyvitamin D3 protects human pancreatic islets against cytokine-induced apoptosis via down-regulation of the Fas receptor. Apoptosis 2006;11: 151–9.
  14. Goswami R, Kochupillai N, Gupta N. Presence of 25 (OH) D deficiencies in a rural North Indian village despite abundant sunshine. J Assoc Physicians India. 2008;56:755-757.
  15. Marwaha RK, Tandon N, Garg MK. Vitamin D status in healthy Indians aged 50 years and above. J Assoc Physicians India. 2011;59:706-709.
  16. Harinarayan CV, Ramalakshmi T, Prasad UV. Vitamin D status in Andhra Pradesh:a population based study. Indian J Med Res. 2008;127:211-218.
  17. Giovannucci E, Liu Y, Hollis BW. 25-Hydroxyvitamin D and risk of myocardial infarction in men: a prospective study. Arch Intern Med. 2008;168:1174-1180.
  18. Scragg R, Jackson R, Holdaway IM. Myocardial infarction is inversely associated with plasma 25-hydroxyvitamin D 3 levels: a community based study. Int J Epidemiol. 1990;19:559-563.
  19. Ayman El-Menyar , study of low Vitamin D and cardiovascular risk fact-ors in males and females from a sunny, rich country .The open cardiovascular medicine journal, 2012, 6, 76-80
  20. Syal SK, Kapoor A, Bhatia E. 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.

Corresponding Author

Vivek Gupta

Registrar, SDM Hospital, Jaipur