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Youthful heart attacks associated with low vitamin D – Nov 2010

Markers of Bone Metabolism in premature myocardial infarction (? 40 years of age).

Bone. 2010 Nov 12
Goliasch G, Blessberger H, Azar D, Heinze G, Wojta J, Bieglmayer C, Wagner O, Schillinger M, Huber K, Maurer G, Haas M, Wiesbauer F.
Department of Cardiology, Vienna General Hospital/Medical University of Vienna and 6Wilhelminen Hospital Vienna.

INTRODUCTION: Acute myocardial infarction (AMI) at young age is a rare disease with a poor prognosis. Bone metabolism parameters such as 1,25 (OH)(2) vitamin D(3), 25 (OH) vitamin D(3) and osteocalcin have been recently implicated in the development of coronary heart disease (CHD). We evaluated the role of these serum markers in a study population of very young AMI survivors (? 40 years).

METHODS AND RESULTS: We prospectively enrolled 302 subjects into our multi-center case control study, including 102 young myocardial infarction patients (? 40 years) and 200 control subjects who were frequency-matched on gender and age in an approximate 2:1 ratio per case patient. In the adjusted logistic regression analysis, we used baseline laboratory measurements for the first analysis (acute phase analysis) and measurements from one-year follow-up visits (stable phase analysis).
In both, elevated levels of 25 (OH) vitamin D(3)
(acute phase: OR per IQR 2.02, 95% CI 1.13- 3.58, p =0.017;
stable phase: OR 4.07, 95% CI 1.8 - 9,21, p =0.001) and
1,25 (OH)(2) vitamin D(3)
(acute phase: OR 2.82, 95% CI 1.7- 4.7, p <0.001;
stable phase: OR 4.57, 95% CI 2.31- 9.05, p <0.001)
were associated with premature AMI. Conversely, osteocalcin was inversely associated with premature myocardial infarction (acute phase: OR 0.53, 95% CI 0.28- 1.03, p =0.059; stable phase: OR 0.26, 95% CI 0.12 - 0.6, p <0,001). The observed associations were independent of the acute phase of myocardial infarction.

CONCLUSION: In our study, elevated levels of 25 (OH) vitamin D(3) and 1,25 (OH)(2) vitamin D(3), as well as decreased levels of osteocalcin were associated with myocardial infarction in very young patients. The precise mechanism and implications of these findings will have to be elucidated in future studies.
Copyright © 2010. Published by Elsevier Inc., PMID: 21078422
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1 year after myocardial infarction patients were 4X more likely to have low level of vitamin D than the controls.

A speculation/prediction about studies in the next few years

  1. Low Vitamin D is a predictor of myocardial infarction for age <40 years
  2. Taking enough vitamin to become sufficient greatly decreases myocardial infarction for age <40 years

See also VitaminDWiki

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