Separham Ahmad, Sohrabi Bahram, Pourafkari Leili, Sepasi Nazli, Ghaffari Samad, Aslanabadi Naser, Nader Nader D
Department of Anesthesiology, University at Buffalo, Buffalo, NY, US.
Turk Kardiyol Dern Ars. 2017 Jun;45(4):324-332. doi: 10.5543/tkda.2017.17737.
Vitamin D (VitD) insufficiency is linked to various chronic conditions, including cardiovascular disease. Aim of the present study was to examine role of serum VitD in resolution of ST segment elevation (STR) in response to thrombolytic therapy following acute ST elevation myocardial infarction (STEMI).
VitD was measured prospectively in all consecutive patients who were admitted with STEMI and received thrombolysis during the calendar year of 2014. STR was defined as ≥50% decrease in initial magnitude of STR 90 minutes after treatment. Multivariate binary logistic regression analysis was performed to identify effect of confounding variables on STR.
Average age was 58±14 years in 227 patients (41 female and 186 male). Total of 24.7% of patients had sufficient VitD (>30 ng/mL), whereas 46.2% had VitD insufficiency (10-30 ng/mL), and remaining 29.1% had VitD deficiency (<10 ng/mL). Significant STR occurred in 57.3% of the patients. In a nonlinear pattern, serum VitD concentration directly correlated with likelihood of STR (p=0.012). VitD deficient patients had larger enzymatic infarct size compared with those with sufficient VitD (p=0.026). In multivariate logistic regression analysis, while diabetes doubled (p=0.033) and involvement of anterior wall created 2.7-fold increase in probability of nonresolution (p=0.001), for every unit increase in serum VitD, likelihood of STR increased by 2.1% (p=0.023).
VitD deficiency in patients with STEMI was associated with lower occurrence of STR and larger enzymatic infarct size in response to thrombolytic therapy.
维生素D（VitD）不足与包括心血管疾病在内的多种慢性疾病相关。本研究的目的是探讨血清VitD在急性ST段抬高型心肌梗死（STEMI）溶栓治疗后ST段抬高（STR）消退中的作用。
对2014年日历年期间因STEMI入院并接受溶栓治疗的所有连续患者进行前瞻性VitD检测。STR定义为治疗后90分钟时STR初始幅度下降≥50%。进行多变量二元逻辑回归分析以确定混杂变量对STR的影响。
227例患者（41例女性和186例男性）的平均年龄为58±14岁。共有24.7%的患者VitD充足（>30 ng/mL），而46.2%的患者VitD不足（10 - 30 ng/mL），其余29.1%的患者VitD缺乏（<10 ng/mL）。57.3%的患者出现显著的STR。血清VitD浓度与STR的可能性呈非线性直接相关（p = 0.012）。与VitD充足的患者相比，VitD缺乏的患者酶促梗死面积更大（p = 0.026）。在多变量逻辑回归分析中，糖尿病使不消退的概率增加一倍（p = 0.033），前壁受累使不消退的概率增加2.7倍（p = 0.001），血清VitD每增加一个单位，STR的可能性增加2.1%（p = 0.023）。
STEMI患者VitD缺乏与溶栓治疗后STR发生率较低及酶促梗死面积较大有关。
