Left ventricular adverse remodeling after myocardial infarction and its association with vitamin D levels.
Int J Cardiol. 2018 Aug 18. pii: S0167-5273(18)30354-1. doi: 10.1016/j.ijcard.2018.08.052.
Padoan L1, Beltrami AP2, Stenner E3, Beleù A1, Ruscio M3, Sinagra G1, Aleksova A4.
1 Cardiovascular Department, Azienda Sanitaria Universitaria Integrata di Trieste and University of Trieste, Trieste, Italy.
2 Department of Medical and Biological Sciences, University of Udine, Italy.
3 Department of Laboratory Medicine, Azienda Sanitaria Universitaria Integrata di Trieste, Trieste, Italy.
4 Cardiovascular Department, Azienda Sanitaria Universitaria Integrata di Trieste and University of Trieste, Trieste, Italy. aaleksova at units.it.
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From the web
PDF is available free at Sci-Hub 10.1016/j.ijcard.2018.08.052.
Background: Vitamin D, a potential cardiovascular risk biomarker, has an unclear role in the adverse left ventricle remodeling (LVAR) after acute myocardial infarction (AMI).
Methods: to evaluate the impact of Vitamin D levels on LVAR in a prospective cohort study of patients with AMI.
Results: 253 patients with AMI were studied, 81 of which (32%) developed, in median 4.1 months after AMI, LVAR. Age, sex, risk factors, type and location of the infarction, clinical presentation, timing and mode of revascularization did not differ between patients with and without LVAR. However, patients with LVAR had lower Vitamin D levels (12.6 vs. 18.7 ng/mL, p <0.001), while higher Vitamin D at baseline protected against LVAR (for increase of 10 ng/ml HR 0.74, CI 0.61-0.90, p <0.001). Plasma levels of C Reactive Protein (CRP), peak Troponin I, indexed left ventricular end systolic volume (LVESVI) and NYHA class at discharge predicted, in multivariate analysis, LVAR occurrence at follow-up. Moreover, the inclusion of Vitamin D improved the multivariate model, as shown by the area under the ROC curve (HR 0.82; CI 0.76-0.88, p<0.001). During the follow-up of 25.5 (777) months, patients with LVAR had a worse event-free survival rate (HF, p=0.012; combined event HF/mortality, p=0.006), even when the analysis was restricted to patients with ST-elevation MI (p=0.006).
Conclusions: low Vitamin D levels are associated with post-infarct LVAR.
PMID: 30139699 DOI: 10.1016/j.ijcard.2018.08.052
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