Milazzo Valentina, De Metrio Monica, Cosentino Nicola, Marenzi Giancarlo, Tremoli Elena
Valentina Milazzo, Monica De Metrio, Nicola Cosentino, Giancarlo Marenzi, Elena Tremoli, Centro Cardiologico Monzino, I.R.C.C.S., 20138 Milan, Italy.
World J Cardiol. 2017 Jan 26;9(1):14-20. doi: 10.4330/wjc.v9.i1.14.
Vitamin D deficiency is a prevalent condition, cutting across all ethnicities and among all age groups, and occurring in about 30%-50% of the population. Besides vitamin D established role in calcium homeostasis, its deficiency is emerging as a new risk factor for coronary artery disease. Notably, clinical investigations have suggested that there is an association between hypovitaminosis D and acute myocardial infarction (AMI). Not only has it been linked to incident AMI, but also to increased morbidity and mortality in this clinical setting. Moreover, vitamin D deficiency seems to predispose to recurrent adverse cardiovascular events, as it is associated with post-infarction complications and cardiac remodeling in patients with AMI. Several mechanisms underlying the association between vitamin D and AMI risk can be involved. Despite these observational and mechanistic data, interventional trials with supplementation of vitamin D are controversial. In this review, we will discuss the evidence on the association between vitamin D deficiency and AMI, in terms of prevalence and prognostic impact, and the possible mechanisms mediating it. Further research in this direction is warranted and it is likely to open up new avenues for reducing the risk of AMI.
维生素D缺乏是一种普遍存在的情况,跨越所有种族和所有年龄组,约30%-50%的人口中存在这种情况。除了维生素D在钙稳态中已确立的作用外,其缺乏正成为冠状动脉疾病的一个新的危险因素。值得注意的是,临床研究表明维生素D缺乏与急性心肌梗死(AMI)之间存在关联。它不仅与新发AMI有关,而且在这种临床情况下还与发病率和死亡率增加有关。此外,维生素D缺乏似乎易导致心血管不良事件复发,因为它与AMI患者的梗死后并发症和心脏重塑有关。维生素D与AMI风险之间关联的潜在机制可能涉及多个方面。尽管有这些观察性和机制性数据,但补充维生素D的干预试验仍存在争议。在本综述中,我们将从患病率和预后影响方面讨论维生素D缺乏与AMI之间关联的证据,以及介导这种关联的可能机制。在这个方向上进行进一步研究是有必要的,并且很可能会开辟降低AMI风险的新途径。