Abstract P325: The Prognostic Utility of Vitamin D and Its Seasonal Variation in Chest Pain Patients with Suspected Acute Coronary Syndrome Recruited from a Coastal Population in Western-Norway
Background: Several studies have shown a correlation between low vitamin D levels and cardiovascular risk. Serum concentration of 25-hydroxy-vitamin D (25(OH)D) is an established marker of vitamin D status. The purpose of this study was to assess the prognostic utility of 25(OH)D status in 871 chest-pain patients with suspected acute coronary syndrome (ACS) from Western-Norway.
Methods: Serum samples for determination of 25(OH)D were obtained at admission. Baseline data consisted of serum levels of Troponin T (TnT), high sensitive C-reactive protein, creatinine, glucose, lipids and B-type natriuretic peptide measured in EDTA plasma, as well as clinical parameters, including age, gender, previous MI, angina pectoris, previous revascularizations (percutaneous coronary intervention or coronary artery bypass graft), congestive heart failure, diabetes mellitus, smoking status, hypercholesterolemia (total cholesterol > 250 mg/dl or statin treated hypercholesterolemia), beta-blocker prior to enrolment, hypertension, body mass index and seasons (defined as November through April and May through October). The main endpoint was total mortality in the total population and in the TnT positive group (TnT > 0.01 ng/mL). Multivariate analysis was performed in 794 patients with a complete set of baseline variables.
Results: The mean age was 69.6 and 39% were females. After 24 months follow-up, 136 patients had died. The mean vitamin D value was 53.8 nM (95% CI, 52.2 nM - 55.4 nM) between November 2002 and April 2003, and 50.2 nM (95%CI, 48.1 nM - 52.3 nM) between May 2003 and October 2003; p = 0.008. In the univariate analysis of all cause mortality in the total population, the hazard ratio (HR) for 25(OH)D in the highest quartile as compared to the lowest quartile was 0.63 (95% confidence interval (CI), 0.38 - 1.03), p = 0.065, and in the TnT positive patients the HR was 0.58 (95% CI, 0.33 - 1.03), p = 0.062. No difference in mortality was found between the vitamin D quartiles in the TnT negative population. The results remained statistically non-significant in the multivariate analysis.
Conclusion: In an univariate analysis there was a trend towards higher mortality in the lowest quartile of vitamin D as compared to the highest quartile in our chest pain population with suspected ACS. Furthermore, there was a statistically significant seasonal difference in vitamin D levels.
- © 2012 by American Heart Association, Inc.