Abstract 16033: No Association Between Baseline Vitamin D Levels and Angiographic Severity of Coronary Artery Disease
Background: Vitamin D (Vit D) deficiency has recently been associated with adverse cardiovascular events, including cardiovascular death, myocardial infarction and stroke. However, whether it is mainly associated with the progression of atherosclerosis itself or rather contributes to the destabilization of existing atherosclerotic plaque is not known. To investigate this question, we looked for an association between vitamin D deficiency and angiographic severity of coronary artery disease (CAD).
Methods: Baseline Vit D levels were obtained on 3,413 consecutive patients presenting for clinically indicated coronary angiography. Vit D was stratified into 3 categories: Normal [N]: >30 ng/ml (n=468[14%]), Low [L]: 15–30 ng/ml (n=2,606[76%]), and Very low [VL]: ≥15 ng/ml (n=339[10%]). A CAD severity score was quantified by counting the number (0–3) of major vessels with severe (≤70%) stenosis. Multivariable linear regression, adjusting for baseline clinical variables (including age, gender, hypertension, hyperlipidemia, diabetes, family history, smoking, heart failure, renal failure, prior history of cardiovascular disease and clinical presentation), was used to determine independent associations.
Results: Age averaged 63.5±13 years and 65.7% were male. A total of 1,157 (33.9%), 1,011 (29.6%), 618 (18.1%) and 627 (18.4%) patients were found to have 0, 1, 2 and 3 vessel disease, respectively. Mean CAD score was 1.09±1.06, 1.23±1.10 and 1.18±1.12 for patients with N, L and VL Vit D levels, respectively (p-trend = 0.14). After multivariable adjustment, the association between baseline Vit D levels and angiographic severity of CAD remained insignificant (p=0.16).
Conclusion: Among patients presenting for clinically indicated coronary angiography, there was no significant association between baseline vitamin D levels and the angiographic severity of CAD. The clinical implications of these findings require further study, but do provide epidemiological evidence that the pathophysiological relationship of Vit D deficiency with cardiovascular disease does not relate to the progression of atherosclerosis.
- © 2010 by American Heart Association, Inc.