Abstract 10377: Vitamin D Status is a 2-Year Predictor of All-Cause Mortality and Cardiac Death in Chest Pain Patients: A Prognostic Study from Salta, Northern-Argentina
Background: Several studies have shown a correlation between vitamin D deficiency and cardiovascular risk. We have assessed the prognostic impact of vitamin D status, serum 25-hydroxy-vitamin D (25(OH)D), in 982 chest-pain patients with suspected acute coronary syndrome (ACS) from Salta, Argentina.
Methods: Blood serum samples for determination of 25(OH)D were obtained at admission. Baseline data consisted of Troponin T (TnT), high sensitive C-reactive protein (hsCRP), B-type natriuretic peptide (BNP), creatinine and clinical parameters, including age, gender, assessment of previous MI, angina pectoris, previous revascularizations (percutaneous coronary intervention or coronary artery bypass graft, congestive heart failure, diabetes mellitus, smoking status, hypercholesterolemia (defined as total cholesterol concentrations above 250 mg/dl or statin treated hypercholesterolemia), beta-blocker, arterial hypertension, body mass index and months of the year.
Results: After a follow-up period of 2 years, 119 patients had died. The 25(OH)D levels were significantly lower among patients dying than in long-term survivors, both in the total population and in the TnT positive patients (TnT > 0.01 ng/mL). In a multivariable Cox regression model for all cause mortality and cardiac death within 2 years in the total patient population, the hazard ratio (HR) for 25(OH)D in the highest quartile (Q4) as compared to the lowest quartile (Q1) was 0.38 (95% confidence interval (CI), 0.20-0.75), p = 0.005 and 0.20 (95% CI, 0.07-0.59), p = 0.004, respectively. For all-cause mortality and cardiac death, the HR for 25(OH)D in TnT positive patients were 0.25 (95% CI, 0.11-0.58), p = 0.001 and 0.19 (95% CI, 0.05-0.64), p = 0.008, respectively. See Figure. This biomarker was not shown to have any prognostic impact in the TnT negative patients.
Conclusion: Vitamin D status may act as clinically useful biomarker when obtained at admission in chest pain patients with suspected ACS.
- © 2011 by American Heart Association, Inc.