7X increased chance of death if coronary artery disease and low vitamin D – Oct 2013

Vitamin D serum levels are associated with cardiovascular outcome in coronary artery disease

Eur Heart J (2013) 34 (suppl 1): doi: 10.1093/eurheartj/eht308.P2486
G. Siasos, D. Tousoulis, E. Oikonomou, K. Maniatis, S. Kioufis, M. Zaromitidou, E. Kokkou, S. Mazaris, T. Konsola and C. Stefanadis
University of Athens Medical School, Hippokration General Hospital, Department of Cardiology, Athens, Greece

Purpose: The role of vitamin D in coronary artery disease is under question recently.
We study the diagnostic and prognostic significance of vitamin D status in coronary artery disease (CAD) patients.

Methods: In this cohort study we included 252 CAD patients (mean aged 62±11 years) followed-up for 3 to 36 (median 15) months. The extent of CAD (1 vessel disease (1VD), 2VD and 3VD) was determined by coronary angiography and severity of CAD was evaluated by Gensini score. Measures for vitamin D were performed using Liquid Chromatography Mass Spectrometry technology. Subjects with vitamin D levels above and below 30ng/ml were characterized as having sufficiency and deficiency respectively. The primary end point was the composite of death from cardiovascular causes, cardiovascular events and hospitalization for cardiovascular causes.

Results: From the study population 222 (88%) were categorized as having vitamin D deficiency and 30 subjects as having vitamin D sufficiency (12%). There was no difference between subjects with deficiency and sufficiency in baseline characteristics. There was no association of Vitamin D levels with Gensini score (rho=0.06, p=0.36) and with the extent of CAD [17.75 (11.37-23.53) vs. 18.40 (13.65-23.53) vs. 16.90 (12.97-26.50) ng/ml, p=0.96, for 1VD, 2VD and 3VD respectively]. During the follow up period the primary end point occurred in 24% of the subjects with vitamin D deficiency and in 7% of the subjects with vitamin D sufficiency. Cox-regression analysis after adjustment for multiple confounders such as age, gender, creatinine clearance, gensini score, the presence of dyslipidemia, arterial hypertension, diabetes mellitus, smoking habits and obesity revealed that subjects with vitamin D deficiency have seven times increased hazard (HR=7.24, p=0.05) for the occurrence of primary end point compared to subjects with vitamin D sufficiency.

Conclusion: Vitamin D deficiency is highly prevalent in CAD patients. Importantly, vitamin D deficiency is associated with adverse cardiovascular outcome in this high risk population a finding that must be further evaluated by interventional studies.

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VitaminDWiki guesses

primary end point = death    (7.2X more likely)
vitamin D deficiency cutpoint was apparently < 10 ng

See also VitaminDWiki

• Overview Cardiovascular and vitamin D
• 14X more likely to die after first cardiovascular event if vitamin D deficient – Nov 2012 small study
• Heart patients 10% more likely to die for every 4 ng less vitamin D – May 2011
• All items in Mortality and vitamin D (not just Cardio) 321 items
• Far better to take Vitamin D than a baby aspirin to avoid heart problems
  baby aspirin reduction < 6% best, Vitamin D decreased death by about 100X more
• 6X worse Sudden Cardiac Arrest outcome if low vitamin D – April 2014

See also Vitamin D Council

• Does vitamin D deficiency influence risk of poor cognitive function after cardiac arrest?
  from the author:"The only factors that had a greater impact on poor neurological outcome were the absence of bystander CPR or having a first monitored heart rhythm that was non-shockable.”