急性ST段抬高型心肌梗死患者血清维生素D水平与冠状动脉血栓分级、TIMI血流及心肌灌注分级的关系
Relationship of serum vitamin D levels with coronary thrombus grade, TIMI flow, and myocardial blush grade in patients with acute ST-segment elevation myocardial infarction.
作者信息
Abdallah Abdallah Ahmed, Elrhman Mohamed Ahmed Abd, Elshazly Ahmd, Bastawy Islam
机构信息
Department of Cardiology, Ain Shams University, Cairo, Egypt.
出版信息
Egypt Heart J. 2020 Nov 23;72(1):84. doi: 10.1186/s43044-020-00118-5.
BACKGROUND
Vitamin D deficiency is a prevalent condition that is found in about 30-50% of the general population, and it is increasing as a new risk factor for coronary artery disease. Our study aimed to evaluate the relationship of serum vitamin D levels with coronary thrombus burden, Thrombolysis In Myocardial Infarction flow grade, and myocardial blush grade in patients managed by primary percutaneous coronary intervention for their first acute ST-segment elevation myocardial infarction.
RESULTS
Eighty patients were included in the study with their first acute ST-segment elevation myocardial infarction and were managed by primary percutaneous coronary intervention. According to the serum concentrations of vitamin D, the study population was divided into 2 groups: group A with abnormal vitamin D levels less than 30 ng/ml (50 patients) and group B with normal vitamin D levels equal to or more than 30 ng/ml (30 patients). Angiographic data was recorded before and after coronary intervention. On comparing thrombus grade and initial and post-procedural Thrombolysis In Myocardial Infarction flow between both groups of patients, there was no significant difference (p = 0.327, p = 0.692, p = 0.397). However, myocardial blush grade was better in patients with normal vitamin D levels (p = 0.029) without a significant correlation between vitamin D concentration values and myocardial blush grade (r = 0.164, p = 0.146).
CONCLUSIONS
Patients with first acute ST-segment elevation myocardial infarction and normal vitamin D levels undergoing primary percutaneous coronary intervention had better myocardial blush grade and more successful microvascular reperfusion in comparison with patients with abnormal vitamin D levels. There was no significant difference between the normal and abnormal vitamin D groups regarding the coronary thrombus grade and Thrombolysis In Myocardial Infarction flow.
背景
维生素D缺乏是一种普遍存在的情况，在大约30%-50%的普通人群中都有发现，并且作为冠状动脉疾病的一个新的危险因素，其发生率正在上升。我们的研究旨在评估首次急性ST段抬高型心肌梗死患者接受直接经皮冠状动脉介入治疗时，血清维生素D水平与冠状动脉血栓负荷、心肌梗死溶栓血流分级及心肌灌注分级之间的关系。
结果
80例首次急性ST段抬高型心肌梗死患者纳入研究并接受直接经皮冠状动脉介入治疗。根据维生素D血清浓度，研究人群分为两组：A组维生素D水平异常低于30 ng/ml（50例患者），B组维生素D水平正常等于或高于30 ng/ml（30例患者）。记录冠状动脉介入前后的血管造影数据。比较两组患者的血栓分级以及初始和术后心肌梗死溶栓血流情况，差异无统计学意义（p = 0.327，p = 0.692，p = 0.397）。然而，维生素D水平正常的患者心肌灌注分级更好（p = 0.029），且维生素D浓度值与心肌灌注分级之间无显著相关性（r = 0.164，p = 0.146）。
结论
与维生素D水平异常的患者相比，首次急性ST段抬高型心肌梗死且维生素D水平正常的患者接受直接经皮冠状动脉介入治疗时，心肌灌注分级更好，微血管再灌注更成功。维生素D水平正常组与异常组在冠状动脉血栓分级和心肌梗死溶栓血流方面无显著差异。
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