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Low vitamin d levels predict stroke in patients referred to coronary angiography
Stefan Pilz1, Harald Dobnig, Joachim E Fischer
1Synlab Center of Laboratory Diagnostics, Heidelberg, PO Box 10470, D-69037 Heidelberg, Germany.
Insights
Low vitamin D levels, including 25-hydroxyvitamin D [25(OH)D] and 1,25-dihydroxyvitamin D [1,25(OH)2D], predict fatal strokes in elderly individuals. This suggests vitamin D supplementation may help prevent strokes.
Area of Science:
- Cardiology
- Neurology
- Endocrinology
Background:
- Vitamin D deficiency is prevalent in the elderly population.
- Vitamin D deficiency is a potential contributing factor to cerebrovascular diseases.
Purpose of the Study:
- To investigate the predictive value of low vitamin D levels for fatal stroke.
- To determine if 25-hydroxyvitamin D [25(OH)D] and 1,25-dihydroxyvitamin D [1,25(OH)2D] predict fatal stroke outcomes.
Main Methods:
- The study analyzed data from 3316 patients in the Ludwigshafen Risk and Cardiovascular Health (LURIC) study.
- Measurements of 25(OH)D and 1,25(OH)2D were taken, with seasonal variations accounted for using z-values.
- Follow-up averaged 7.75 years, during which 769 patients died, including 42 fatal strokes.
Main Results:
- Lower levels of both 25(OH)D and 1,25(OH)2D were associated with an increased risk of fatal stroke.
- Odds ratios for fatal stroke decreased significantly per unit increase in 25(OH)D and 1,25(OH)2D z-values.
- Adjusted analyses confirmed the independent predictive value of both vitamin D metabolites for fatal stroke.
Conclusions:
- Low serum concentrations of 25(OH)D and 1,25(OH)2D are independent predictors of fatal stroke.
- Vitamin D supplementation emerges as a potential strategy for stroke prevention.
Background And Purpose:
Vitamin D deficiency is common among the elderly and may contribute to cerebrovascular diseases. We aimed to elucidate whether low vitamin D levels are predictive for fatal stroke.
Methods:
The LUdwigshafen RIsk and Cardiovascular Health (LURIC) study includes 3316 patients who were referred to coronary angiography at baseline between 1997 and 2000. 25-Hydroxyvitamin D [25(OH)D] and 1,25-dihydroxyvitamin D [1,25(OH)2D] were measured in 3299 and 3315 study participants, respectively. To account for the seasonal variation of vitamin D metabolites, we calculated z values for the 25(OH)D and 1,25(OH)2D concentrations within each month of blood draw.
Results:
During a median follow-up time of 7.75 years, 769 patients died, including 42 fatal (ischemic and hemorrhagic) strokes. When compared with survivors in binary logistic-regression analyses, the odds ratios (with 95% CIs) for fatal stroke were 0.58 (0.43 to 0.78; P<0.001) per z value of 25(OH)D and 0.62 (0.47 to 0.81; P<0.001) per z value of 1,25(OH)2D. After adjustment for several possible confounders, these odds ratios remained significant for 25(OH)D at 0.67 (0.46 to 0.97; P=0.032) and for 1,25(OH)2D at 0.72 (0.52 to 0.99; P=0.047). Z values of 25(OH)D and 1,25(OH)2D were also reduced in the 274 patients who had a history of previous cerebrovascular disease events at baseline.
Conclusions:
Low levels of 25(OH)D and 1,25(OH)2D are independently predictive for fatal strokes, suggesting that vitamin D supplementation is a promising approach in the prevention of strokes.
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