Javadzadegan Hassan, Separham Ahmad, Farokhi Aidin, Applegate Camille, Nader Nader D
Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA.
Acta Cardiol. 2023 Feb;78(1):40-46. doi: 10.1080/00015385.2021.2015144. Epub 2022 Jul 11.
To investigate the role of vitamin D2 on the resolution of ST-segment elevation (STE) after a primary percutaneous coronary intervention (PCI), as serum levels of vitamin D have been associated with the severity of coronary artery disease.
All patients who underwent PCI for STEMI were screened for enrolment. Vitamin D2 levels were measured on admission along with other biochemical and haematologic assays. The electrocardiography (ECG) was recorded upon arrival and 60 min after the completion of PCI. The primary endpoint of the study was a ≥ 50% resolution of ST-segment amplitude (+STR) when compared to the initial ECG. A logistic regression multivariate analysis was performed to examine the association of STR with all confounding variables, including the admission levels of vitamin D. Receiver-operator characteristics analysis was used to determine the cut-off value of vitamin D that was predictive of STR. Although there was no difference in STR based on standard classification of vitamin D sufficiency, critically low levels of vitamin D (<7.5 ng/mL) were significantly associated with the absence of STR after PCI (AUC was 0.65 ± 0.07; < 0.001). Critical vitamin D deficiency was a moderate predictor of STR in these patients, with a sensitivity of 86% and specificity of 54%.
We concluded that although levels below ten ng/mL were generally accepted as vitamin D deficiency, only critically low levels of this vitamin (<7.5 ng/dL) reliably predicted the resolution of ST-segment after a primary PCI for patients with STEMI.
研究维生素D2在直接经皮冠状动脉介入治疗（PCI）后ST段抬高（STE）消退中的作用，因为血清维生素D水平与冠状动脉疾病的严重程度相关。
对所有因ST段抬高型心肌梗死（STEMI）接受PCI治疗的患者进行筛选以纳入研究。入院时测量维生素D2水平以及其他生化和血液学指标。到达时及PCI完成后60分钟记录心电图（ECG）。研究的主要终点是与初始ECG相比，ST段振幅（+STR）消退≥50%。进行逻辑回归多变量分析以检验STR与所有混杂变量的关联，包括入院时的维生素D水平。采用受试者工作特征分析来确定预测STR的维生素D临界值。尽管基于维生素D充足标准分类的STR无差异，但维生素D极低水平（<7.5 ng/mL）与PCI后STR缺失显著相关（AUC为0.65±0.07；P<0.001）。严重维生素D缺乏是这些患者STR的中度预测指标，敏感性为86%，特异性为54%。
我们得出结论，尽管一般认为低于10 ng/mL的水平为维生素D缺乏，但只有这种维生素的极低水平（<7.5 ng/dL）能可靠地预测STEMI患者直接PCI后ST段的消退情况。
