Hajimoradi Behzad, Hosseini Behnaz, Alirezaei Toktam, Pourmotahari Fatemeh
Shohada Tajrish Hospital, Shahid Beheshti University of Medical Science.
Shahid Beheshti University of Medical Science.
Cardiovasc Hematol Disord Drug Targets. 2022 Apr 18. doi: 10.2174/1871529X22666220418111905.
A better identification of the role of vitamin D in the thrombotic process of acute coronary syndrome (ACS) will help increase the therapeutic options for this important clinical condition. There is little published evidence that 25-hydroxy vitamin D (25(OH)D) serum levels can associate with platelet function and risk of thrombosis.
This prospective study was conducted on 200 patients with a diagnosis of ACS, including patients with unstable angina (UA), non-ST segment elevation myocardial infarction (NSTEMI), and ST segment elevation myocardial infarction (STEMI). In addition to demographics and angiographic data, serum concentrations of 25(OH)D and MPV were recorded in all patients.
The types of ACS were STEMI (35%), NSTEMI (25%), and UA (40%). The concentrations of 25(OH)D in patients with UA, NSTEMI, and STEMI were 23.53 ± 13.26, 19.25 ± 8.09 and 14.60 ± 8.24 ng/mL respectively (P < 0.001), and the values of MPV were 9.83 ± 1.35, 10.30 ± 1.21, and 11.56 ± 1.38 fL, respectively (P < 0.001). There was a negative correlation between 25(OH)D and MPV (R = -0.320, P < 0.0001). ROC analysis illustrated a moderate predictive value (AUC 0.706; 95% CI, 0.63-0.72) in identifying the discrimination threshold of MPV (≥ 9.90 fL) for vitamin D deficiency (<20 ng/mL).
The current study shows an inverse association between MPV and vitamin D levels in ACS patients, especially in the subgroup of STEMI. These findings propose the effect of vitamin D on platelet size and function, suggesting its role in thrombosis and hemostasis, which might explain the link between vitamin D deficiency and cardiovascular diseases.
更好地明确维生素D在急性冠状动脉综合征（ACS）血栓形成过程中的作用，将有助于增加针对这一重要临床病症的治疗选择。几乎没有已发表的证据表明25-羟维生素D（25(OH)D）血清水平与血小板功能及血栓形成风险相关。
本前瞻性研究对200例诊断为ACS的患者进行，包括不稳定型心绞痛（UA）、非ST段抬高型心肌梗死（NSTEMI）和ST段抬高型心肌梗死（STEMI）患者。除人口统计学和血管造影数据外，还记录了所有患者的25(OH)D血清浓度和平均血小板体积（MPV）。
ACS类型为STEMI（35%）、NSTEMI（25%）和UA（40%）。UA、NSTEMI和STEMI患者的25(OH)D浓度分别为23.53±13.26、19.25±8.09和14.60±8.24 ng/mL（P<0.001），MPV值分别为9.83±1.35、10.30±1.21和11.56±1.38 fL（P<0.001）。25(OH)D与MPV呈负相关（R=-0.320，P<0.0001）。ROC分析表明，在确定维生素D缺乏（<20 ng/mL）时MPV的判别阈值（≥9.90 fL）方面具有中等预测价值（AUC 0.706；95%CI，0.63 - 0.72）。
当前研究表明ACS患者中MPV与维生素D水平呈负相关，尤其是在STEMI亚组中。这些发现提示了维生素D对血小板大小和功能的影响，表明其在血栓形成和止血中的作用，这可能解释了维生素D缺乏与心血管疾病之间的联系。
