Department of Clinical Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.
Clin Res Cardiol. 2012 May;101(5):321-7. doi: 10.1007/s00392-011-0394-0. Epub 2011 Dec 11.
Low serum level of vitamin D was shown to be associated with cardiovascular diseases as well as the presence of diabetes, dyslipidemia, and hypertension. Vitamin D deficiency is a global problem, and is an Iranian problem as well. To the best of our knowledge, this was the first study on acute myocardial infarction that evaluates the correlation of vitamin D level with inpatients' outcomes, particularly on the early biomarkers of myocardial remodeling.
In a prospective study, patients with acute ST segment elevation myocardial infarction were included. The patients' 25 (OH) D levels were identified and the associations with clinical characteristics, including early remodeling biomarkers and in-hospital outcomes, were investigated.
From the 139 included patients, 80.5% were male. The 25 (OH) deficiency was present in 72.7% of the patients. Hypertension and positive history of cardiovascular drug use were risk factors for the presence of low vitamin D levels (OR = 2.92; CI = 1.34-6.37, P < 0.05) and (OR = 2.36; CI = 1.05-5.29, P < 0.05), respectively. Moreover, a significant positive relationship between the inpatients' survival and the concentration of vitamin D was present (P < 0.001). By performing a multivariate analysis, we found that there was a significant inverse relationship between the level of 25 (OH) D and the level of MMP-9 after 72 h (P = 0.011).
The results of our study revealed a significant inverse relationship between serum MMP-9 as a biomarker of early remodeling and the level of 25(OH) D in patients after an acute myocardial infarction. Moreover, low level of vitamin D was associated with patients' mortality in this study.
已有研究表明,血清维生素 D 水平较低与心血管疾病以及糖尿病、血脂异常和高血压的发生有关。维生素 D 缺乏是一个全球性问题,也是伊朗存在的问题。据我们所知,这是第一项评估维生素 D 水平与住院患者预后相关性的急性心肌梗死研究,特别是评估维生素 D 水平与心肌重构早期生物标志物的相关性。
在一项前瞻性研究中,纳入了急性 ST 段抬高型心肌梗死患者。确定了患者的 25(OH)D 水平,并研究了其与临床特征的相关性,包括早期重构生物标志物和住院期间的结局。
在纳入的 139 例患者中,80.5%为男性。72.7%的患者存在 25(OH)D 缺乏。高血压和心血管药物使用阳性史是维生素 D 水平降低的危险因素(OR=2.92;95%CI=1.34-6.37,P<0.05)和(OR=2.36;95%CI=1.05-5.29,P<0.05)。此外,患者存活率与维生素 D 浓度之间存在显著正相关(P<0.001)。通过多变量分析,我们发现 25(OH)D 水平与 72 小时后 MMP-9 水平之间存在显著的负相关(P=0.011)。
本研究结果表明,血清 MMP-9 作为早期重构的生物标志物与急性心肌梗死后患者 25(OH)D 水平之间存在显著的负相关。此外,本研究中维生素 D 水平较低与患者死亡率相关。