ID: 2: VITAMIN D AND ITS ASSOCIATION IN OBSTRUCTIVE, NON-OBSTRUCTIVE CORONARY ARTERY DISEASE, AND NORMAL CORONARIES ASSESSED ON CORONARY ANGIOGRAPHY

2016 ◽  
Vol 64 (4) ◽  
pp. 919.2-920
Author(s):  
R Sogomonian ◽  
H Alkhawam ◽  
J Jolly ◽  
N Vyas ◽  
S Ahmad ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Vitamin D ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Vitamin D Deficiency ◽  
Coronary Disease ◽  
Obstructive Coronary Artery Disease ◽  
Dihydroxyvitamin D ◽  
Vitamin D Levels ◽  
Artery Disease

BackgroundPro-atherosclerotic nature of vitamin D deficiency has been shown to increase cardiovascular events. To further demonstrate this phenomenon, we evaluated the degree of coronary artery disease (CAD) with varying levels of vitamin D.MethodA retrospective, single-center study of 9,399 patients admitted between 2005 and 2014 for chest pain who underwent coronary angiography. Patients without a vitamin D level, measured as 25-dihydroxyvitamin D (25[OH]D) were excluded from our study. 25(OH)D deficiency and insufficiency were defined by having serum concentration levels of less than 20 ng/ml and 20 to 29.9 ng/ml, respectively, while normal levels were defined as greater than or equal to 30 ng/ml. We assessed the degree of 25(OH)D and the extent of coronary disease with coronary angiography as obstructive CAD (left main stenosis of ≥50% or any stenosis of ≥70%), non-obstructive CAD (≥1 stenosis ≥20% but no stenosis ≥70%) and normal coronaries (no stenosis >20%).ResultsAmong 9,399 patients, 1,311 qualified, of which 308 patients (23%) had normal 25(OH)D levels, 552 patients (42%) had 25(OH)D deficiency and 451 patients (35%) had 25(OH)D insufficiency. In an analysis for the extent of coronary disease we identified 259 patients (20%) having normal coronaries, 720 patients (55%) with obstructive CAD and 291 patients (25%) with non-obstructive CAD.Baseline clinical risk factors, and co-morbidities did not differ in either groups. Patients with 25(OH)D deficiency and insufficiency (n=1003) developed symptomatic CAD at a mean age of 63-years-old versus 67 with normal 25(OH)D (n=308, p<0.0001).Patients with normal 25(OH)D levels were found to have normal coronaries compared to patients with 25(OH)D deficiency or insufficiency (OR: 7, 95% CI: 5.2–9.5, p<0.0001). Comparing patients with normal 25(OH)D levels, in patients with 25(OH)D deficiency or insufficiency (<29 ng/ml), 65% were found to have obstructive CAD (n=612, OR: 2.9, 95% CI: 2.3–3.7, p<0.0001) and 24% had non-obstructive CAD (n=237, OR: 1.5, 95% CI: 1.1–2, p=0.02).In a head-to-head, sub-grouped comparison, patients with 25(OH)D deficiency and insufficiency were found to have obstructive CAD (n=394, OR: 2.7, 95% CI: 2–3.4, p<0.0001) and non-obstructive CAD (n=169, OR: 2.6, 95% CI: 2–3.4, p<0.0001), respectively.ConclusionVitamin D deficiency and insufficiency correlate with obstructive and non-obstructive CAD, respectively. Normal coronaries were shown to be related with normal levels of vitamin D. Vitamin D levels may provide benefit in improving risk stratification for patients with CAD as a possible modifiable risk factor. Further studies may be needed to enhance our findings.

Study on Vitamin D deficiency in patients of diabetes mellitus presenting with Acute Coronary syndrome in a tertiary care hospital in South India

2020 ◽  
Vol 11 (5) ◽  
pp. 49-53
Author(s):  
Archana Bhat ◽  
Arunachalam Ramachandran ◽  
Pradeep Periera ◽  
Akshatha Rao Aroor
Keyword(s):  
Diabetes Mellitus ◽  
Coronary Artery Disease ◽  
Vitamin D ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Vitamin D Deficiency ◽  
Coronary Syndrome ◽  
Vitamin D Levels ◽  
Luminal Stenosis ◽  
Artery Disease

Background: Vitamin D, a fat-soluble vitamin has its receptor present in myriad of tissues and it modulates multiple cellular processes. Vitamin D deficiency is reported to be associated with coronary artery disease. Cardiovascular disease is the leading cause of mortality worldwide. Aims and Objective: The primary outcome was to investigate if there is a correlation of 25-OH levels with the percentage of luminal stenosis, as measured with coronary angiogram. The secondary outcome was to determine the differences in angiographically proven luminal stenosis across categories of 25-OH vitamin D levels. Materials and Methods: Thirty patients with acute coronary syndrome with diabetes mellitus were included in this cross-sectional descriptive study. All patients were tested for fasting vitamin D levels, fasting blood sugar, HbA1C and serum creatinine. Detailed history of the patients was recorded. Data was analyzed by the statistical software SPSS version 19 and p value <0.05 was considered significant. Statistical tests like Chi- square, independent t test and log regression was used. Results: In this study 30 patients undergoing coronary angiography for acute coronary syndrome, Vitamin D levels showed severe deficiency in 6.7% (2) cases while mild deficiency was seen in 50% of the cases. Patients with single vessel disease on the coronary angiogram had lower mean HbA1C (9.18) levels in our study. Patients with triple vessel disease had poorly controlled mean HbA1C levels (10.42). Conclusion: In this study we did not find any significant difference between the serum Vitamin D deficiency levels with patients with angiographic severity of the coronary artery disease. Patients with poorly controlled diabetes mellitus had more severe angiographic proven coronary artery disease.

scholarly journals Serum Vitamin D Level in Patients with Coronary Artery Disease and Association with Sun Exposure: Experience from a Tertiary Care, Teaching Hospital in India

2019 ◽  
Vol 2019 ◽  
pp. 1-4 ◽  
Author(s):  
Tauseef Akhtar ◽  
Ramesh Aggarwal ◽  
Sachin Kumar Jain
Keyword(s):  
Coronary Artery Disease ◽  
Vitamin D ◽  
Coronary Artery ◽  
Vitamin D Deficiency ◽  
Tertiary Care ◽  
Serum Vitamin ◽  
Sun Exposure ◽  
Serum Vitamin D ◽  
Vitamin D Levels ◽  
Artery Disease

Background. Vitamin D, a fat-soluble vitamin, has various extraskeletal effects, and several human and animal studies have suggested that vitamin D deficiency may be a contributory factor in the pathogenesis of coronary artery disease (CAD). However, such studies in the Indian subcontinent are either lacking or have shown conflicting results. Methods. This was a descriptive cross-sectional study involving 121 patients with CAD from a tertiary care center and their 80 age-matched healthy controls. Serum vitamin D levels along with serum and urine chemistries were measured in both the groups. The average duration of sun exposure/day and use of sunscreen were also considered in the study cohort using a questionnaire. Serum vitamin D levels were categorized into deficient (<30 nmol/lit), insufficient (30–75 nmol/lit), and sufficient (>75 nmol/lit) groups. Results. Among the cases, 51.2% of the patients were vitamin D deficient and 44.6% patients had insufficient vitamin D levels, whereas among controls, 40% and 31% of the population had deficient and insufficient levels of vitamin D, respectively. However, the mean value of the serum vitamin D level was not statistically different in the cases as compared to that of the controls (34.06 vs 40.19 nmol/lit) (P=0.08). Corrected serum calcium (9.26 vs 9.59 mg%) (P≤0.0001) and serum albumin levels (4.21 vs 4.75 gm%) (P≤0.0001) were lower in the cases than those of the controls. The average sun exposure/day was higher among the cases than that among the controls (2.93 vs 1.85 hours) (P=0.001). Conclusion. Vitamin D deficiency is widely prevalent in Indian population despite abundant sunshine, and the duration of sun exposure is not correlated with serum vitamin D levels. Vitamin D deficiency is not associated with CAD. However, serum calcium is deficient in CAD patients as compared to the controls. Large-scale studies are required to explore the association further to evaluate the benefits of screening and correction of vitamin D deficiency in patients with CAD.

Abstract 342: Impact Of System And Physician Factors On The Diagnostic Yield Of Coronary Angiography In Stable Ischemic Heart Disease: A Population Based Study

2014 ◽  
Vol 7 (suppl_1) ◽  
Author(s):  
Harindra C Wijeysundera ◽  
Feng Qiu ◽  
Maria C Bennell ◽  
Madhu K Natarajan ◽  
Warren J Cantor ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Heart Disease ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Ischemic Heart Disease ◽  
Diagnostic Yield ◽  
Obstructive Coronary Artery Disease ◽  
Ischemic Heart ◽  
Patient Factors ◽  
Artery Disease

Background: Wide variation exists in the diagnostic yield of coronary angiography in stable ischemic heart disease (IHD). Previous work has primarily focused on patient factors for this variation. We sought to understand if system and physician factors, specifically hospital and physician type, as well as physician self-referral, have incremental impacts on the yield of coronary angiography, above and beyond that of patient factors alone. Methods: All patients who underwent a diagnostic coronary angiogram for possible stable IHD, at the 18 cardiac centers in Ontario, Canada were identified from October 1st, 2008 to September 30th, 2011. Obstructive coronary artery disease was defined as stenosis greater than 70% in the main coronary arteries or greater than 50% in the left main artery. Physicians were classified as either invasive or interventional. Hospitals were categorized into cath only, stand-alone PCI and full service centers. Multi-variable hierarchical logistic models were developed to identify system and physician level predictors of obstructive coronary artery disease, having adjusted for patient factors. Results: Our cohort consisted of 60,986 patients who underwent a diagnostic angiogram for possible stable IHD, of which 33,483 had obstructive coronary artery disease (54.9%), ranging from 41.0% to 70.2% across centers. Self-referral rates varied from 4.8% to 74.6%. Fewer self-referral patients (52.5%) had obstructive coronary artery disease compared to non-self-referral patients (56.5%), with an odds ratio (OR) of 0.89 (95% CI 0.85-0.93;p <0.001), after accounting for patient factors. Angiograms performed by interventional physicians had a higher likelihood of showing obstructive coronary artery disease (60.1% vs. 50.8%; OR 1.22; 95% CI 1.17-1.28; p<0.001). Fewer angiograms at cath only centers showed obstructive disease (45.0%) compared to full service centers (58.1%); this was of borderline significance (OR 0.59; 95% CI 0.34-1.00; p=0.05). Conclusion: Physician and system factors are important predictors of the diagnostic yield of coronary angiography in stable IHD, even after accounting for patient characteristics. Further study into the drivers of how these physician and system factors impact diagnostic yield is an important focus for quality improvement.

Vitamin D Deficiency is Associated With the Development of Subclinical Coronary Artery Disease in African Americans With HIV Infection

2012 ◽  
Vol 60 (5) ◽  
pp. 801-807 ◽  
Author(s):  
Hong Lai ◽  
Barbara Detrick ◽  
Elliot K. Fishman ◽  
Gary Gerstenblith ◽  
Jeffrey A. Brinker ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Vitamin D ◽  
Coronary Artery ◽  
African Americans ◽  
Hiv Infection ◽  
Vitamin D Deficiency ◽  
Artery Disease

scholarly journals VITAMIN D DEFICIENCY IS INDEPENDENTLY ASSOCIATED WITH THE EXTENT OF CORONARY ARTERY DISEASE

2014 ◽  
Vol 63 (12) ◽  
pp. A1602
Author(s):  
Monica Verdoia ◽  
Alon Schaffer ◽  
Lucia Barbieri ◽  
Ettore Cassetti ◽  
Paolo Marino ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Vitamin D ◽  
Coronary Artery ◽  
Vitamin D Deficiency ◽  
Artery Disease
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