Serum 25(OH)D is a 2-year predictor of all-cause mortality, cardiac death and sudden cardiac death
in chest pain patients from Northern Argentina.
PLoS One. 2012;7(9):e43228. doi: 10.1371/journal.pone.0043228. Epub 2012 Sep 6.
Naesgaard PA, León De La Fuente RA, Nilsen ST, Woie L, Aarsland T, Brede C, Staines H, Nilsen DW.
Department of Cardiology, Stavanger University Hospital, Stavanger, Norway.
BACKGROUND: Several studies have shown an association between vitamin D deficiency and cardiovascular risk.
Vitamin D status is assessed by determination of 25-hydroxyvitamin D [25(OH)D] in serum.
METHODS: We assessed the prognostic utility of 25(OH)D in 982 chest-pain patients with suspected acute coronary syndrome (ACS) from Salta, Northern Argentina. 2-year follow-up data including all-cause mortality, cardiac death and sudden cardiac death were analyzed in quartiles of 25(OH)D, applying univariate and multivariate analysis.
RESULTS:There were statistically significant changes in seasonal 25(OH)D levels. At follow-up, 119 patients had died. The mean 25(OH)D levels were significantly lower among patients dying than in long-term survivors, both in the total population and in patients with a troponin T (TnT) release (n = 388). When comparing 25(OH)D in the highest quartile to the lowest quartile in a multivariable Cox regression model for all-cause mortality, the hazard ratio (HR) for cardiac death and sudden cardiac death in the total population was 0.37 (95% CI, 0.19-0.73), p = 0.004, 0.23 (95% CI, 0.08-0.67), p = 0.007, and 0.32 (95% CI, 0.11-0.94), p = 0.038, respectively. In patients with TnT release, the respective HR was 0.24 (95% CI, 0.10-0.54), p = 0.001, 0.18 (95% CI, 0.05-0.60), p = 0.006 and 0.25 (95% CI, 0.07-0.89), p = 0.033. 25(OH)D had no prognostic value in patients with no TnT release.
CONCLUSION:Vitamin D was shown to be a useful biomarker for prediction of mortality when obtained at admission in chest pain patients with suspected ACS.
TRIAL REGISTRATION:ClinicalTrials.gov NCT01377402.
The troponin test measures the levels of certain proteins called troponin T and troponin I in the blood.
These proteins are released when the heart muscle has been damaged, such as a heart attack.
The more damage there is to the heart, the greater the amount of troponin T and I there will be in the blood.
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