Baktır Ahmet Oğuz, Doğan Yasemin, Şarlı Bahadır, Şahin Ömer, Demirci Erkan, Akpek Mahmut, Özkan Eyüp, Arınç Hüseyin, Sağlam Hayrettin
Department of Cardiology, Kayseri Education and Research Hospital; Kayseri-Turkey.
Anatol J Cardiol. 2017 Apr;17(4):293-297. doi: 10.14744/AnatolJCardiol.2016.6977. Epub 2017 Feb 1.
The extent of severity and complexity of coronary artery disease (CAD) in patients presenting with ST-segment elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI) and possible correlations between serum 25-hydroxyvitamin D (25(OH)D) have not yet been adequately studied. We evaluated the relationship between 25(OH)D levels and the burden of CAD as assessed by the SYNTAX score (SXscore) in patients with acute coronary syndrome (ACS) including STEMI and NSTEMI.
After exclusion, a total of 113 patients who were admitted to our hospital due to ACS and who were referred for undergoing coronary angiography were prospectively included. Their mean age was 63.3±18.5 years, and 80.5% of them were men. In total, 44.2% of the patients had NSTEMI and the remaining had STEMI. Blood samples were drawn at admission to evaluate serum 25(OH)D levels. CAD severity was assessed using the SXscore. Patients were classified as having low (SXscore ≤22) or high (SXscore >22) SXscores. Pearson's and Spearman's correlation coefficients were used to examine the relationship between serum 25(OH)D levels and the SXscore.
25(OH)D levels were significantly lower in the group with a high SXscore than in the group with a low SXscore (21.0±8.0 vs. 16.7±6.8, p=0.005). Correlation analysis showed a significant correlation between 25(OH)D levels and the SXscore. Multiple linear regression (MLR) analysis was used to determine the significance of the relationship between the SXscore and 25(OH)D, parathyroid hormone, and C-reactive protein levels and eGFR. MLR analysis revealed that only 25(OH)D levels (coefficient beta, -0.217, p=0.029) was significantly associated with the severity of CAD.
The present study showed that serum 25(OH)D levels were significantly lower in patients with STEMI/NSTEMI and that low serum 25(OH)D levels were significantly correlated with CAD severity and extent.
ST段抬高型心肌梗死（STEMI）和非ST段抬高型心肌梗死（NSTEMI）患者冠状动脉疾病（CAD）的严重程度和复杂性以及血清25-羟基维生素D（25(OH)D）之间可能存在的相关性尚未得到充分研究。我们评估了急性冠状动脉综合征（ACS，包括STEMI和NSTEMI）患者中25(OH)D水平与通过SYNTAX评分（SXscore）评估的CAD负担之间的关系。
排除后，前瞻性纳入了因ACS入院并被转诊接受冠状动脉造影的113例患者。他们的平均年龄为63.3±18.5岁，其中80.5%为男性。总共有44.2%的患者患有NSTEMI，其余患者患有STEMI。入院时采集血样以评估血清25(OH)D水平。使用SXscore评估CAD严重程度。患者被分类为SXscore低（SXscore≤22）或高（SXscore>22）。采用Pearson和Spearman相关系数来检验血清25(OH)D水平与SXscore之间的关系。
SXscore高的组中25(OH)D水平显著低于SXscore低的组（21.0±8.0 vs. 16.7±6.8，p=0.005）。相关性分析显示25(OH)D水平与SXscore之间存在显著相关性。采用多元线性回归（MLR）分析来确定SXscore与25(OH)D、甲状旁腺激素、C反应蛋白水平和估算肾小球滤过率（eGFR）之间关系的显著性。MLR分析显示只有25(OH)D水平（系数β，-0.217，p=0.029）与CAD严重程度显著相关。
本研究表明，STEMI/NSTEMI患者的血清25(OH)D水平显著较低，且低血清25(OH)D水平与CAD严重程度和范围显著相关。
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