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Lower vitamin D level is associated with poor coronary collateral circulation
Irfan Sahin1, Ertugrul Okuyan, Baris Gungor
1Department of Cardiology, Bagcilar Training and Research Hospital , Istanbul , Turkey.
Insights
Lower vitamin D levels are linked to poorer coronary collateral circulation in patients with stable coronary artery disease (CAD). This suggests vitamin D may play a role in the development of these vital blood vessels.
Area of Science:
- Cardiovascular Medicine
- Endocrinology
- Nutritional Science
Background:
- Vitamin D is crucial for calcium and bone homeostasis and parathyroid hormone (PTH) secretion.
- Previous studies suggest links between low vitamin D and cardiovascular diseases.
- The association between vitamin D and coronary collateral circulation (CCC) in stable coronary artery disease (CAD) remains unexplored.
Purpose of the Study:
- To investigate the relationship between vitamin D levels and collateral artery development in patients with stable CAD.
- To determine if vitamin D deficiency is associated with poor CCC in this patient population.
Main Methods:
- A cohort of 214 patients with significant coronary artery stenosis underwent coronary angiography (CAG).
- Coronary collateral circulation (CCC) was assessed using the Rentrop classification, categorizing patients into poor (Grade 0-1) and control (Grade 2-3) groups.
- Serum vitamin D and PTH levels were measured on the day of CAG.
Main Results:
- Patients with poor CCC exhibited significantly lower vitamin D levels (34 ± 25 pmol/L vs. 49 ± 33 pmol/L; p=0.01).
- The prevalence of vitamin D deficiency (< 37 pmol/L) was higher in the poor CCC group (67% vs. 43%; p=0.01).
- Lower vitamin D levels, female gender, and lower HDL cholesterol were independently associated with poor CCC.
Conclusions:
- Reduced vitamin D levels are associated with impaired collateral artery development in patients with stable CAD.
- These findings highlight a potential role for vitamin D in coronary collateralization.
Objectives:
Vitamin D regulates calcium and bone homeostasis, and parathyroid hormone (PTH) secretion. Cross-sectional associations between lower vitamin D levels and cardiovascular diseases have been reported, but the relationship between vitamin D levels and collateral arteries in stable coronary artery disease (CAD) has not been reported before.
Design:
Two hundred and fourteen patients with above 95% stenosis in at least one epicardial coronary artery were consecutively recruited after coronary angiography (CAG) during the winter season. The coronary collateral circulation (CCC) was graded using Rentrop classification. Poor CCC group included patients with Rentrop Grade 0-1 CCC and control group included patients with Rentrop Grade 2-3 CCC. Vitamin D and PTH levels were measured on the day of CAG.
Results:
In the poor CCC group, vitamin D levels were lower (34 ± 25 pmol/L vs. 49 ± 33 pmol/L; p = 0.01) and the prevalence of vitamin D deficiency (< 37 pmol/L) was higher (67% vs. 43%; p = 0.01) compared to the controls. PTH levels, calcium, and phosphate levels were not significantly different between the groups. Female gender, lower HDL cholesterol, and lower vitamin D levels were independently correlated with poor CCC in the study population.
Conclusion:
Lower vitamin D levels may be associated with poor collateral development in patients with stable CAD.
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