Vitamin D replacement therapy in patients with cardiac syndrome X

Area of Science:

• Cardiology
• Endocrinology
• Nutritional Science

Background:

• Cardiac Syndrome X (CSX) is characterized by angina symptoms despite normal coronary angiograms.
• Low serum vitamin D levels are prevalent in cardiovascular patients and linked to adverse outcomes.
• Vitamin D's known cardiovascular benefits suggest a potential role in managing CSX.

Purpose of the Study:

• To investigate the efficacy of vitamin D replacement therapy in patients with CSX and vitamin D deficiency.
• To assess the impact of vitamin D on angina frequency and exercise-induced ischemia.

Main Methods:

• A study cohort of patients with CSX and low serum vitamin D was treated with intramuscular vitamin D3 (300,000 units every other week for 2 months).
• Angina episodes per day and exercise capacity indices were measured before and after treatment.
• Serum vitamin D3 levels were monitored to confirm repletion.

Main Results:

• Vitamin D replacement normalized serum vitamin D3 levels (45±8 ng/ml).
• Significant improvements were observed in angina frequency (p=0.003), exercise duration (p<0.001), and maximal work capacity (p<0.001).
• Exercise-induced ischemia markers, including maximal ST-segment depression and Duke treadmill score, significantly improved (p=0.001).

Conclusions:

• Vitamin D replacement therapy is effective in improving symptoms and objective signs of ischemia in patients with CSX and vitamin D deficiency.
• This intervention offers a potential therapeutic strategy for managing cardiac syndrome X.
• Addressing vitamin D deficiency may be crucial for optimizing cardiovascular health in susceptible populations.