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Status of Plasma Vitamin-D Level in Predicting Adverse In-Hospital Outcome in Patients with First Attack of Acute
J U Sharif1, M M Islam, M A Bari
1Dr Jahir Uddin Mohammed Sharif, Junior Consultant, Department of Cardiology, Mymensingh Medical College Hospital (MMCH), Mymensingh, Bangladesh;
Insights
Low plasma vitamin D levels are linked to increased in-hospital adverse cardiac events in patients with acute myocardial infarction (MI). This finding highlights vitamin D as a crucial predictor for cardiovascular outcomes post-MI.
Area of Science:
- Cardiology
- Endocrinology
- Public Health
Background:
- Acute myocardial infarction (MI) presents significant in-hospital risks.
- Plasma vitamin D levels are emerging as a predictor of cardiovascular outcomes.
- Identifying individuals at risk for coronary artery disease (CAD) and related events is crucial.
Purpose of the Study:
- To investigate the predictive role of plasma vitamin D levels for in-hospital adverse cardiac events in patients experiencing their first acute MI.
- To establish vitamin D as a potential biomarker for cardiovascular risk stratification.
Main Methods:
- A cross-sectional descriptive study involving 257 first-time acute MI patients.
- Plasma vitamin D levels were analyzed, categorizing participants into normal (>30 ng/ml) and low (insufficiency, deficiency, severe deficiency) groups.
- In-hospital adverse cardiac outcomes were monitored and statistically analyzed.
Main Results:
- Higher incidence of adverse outcomes, including heart failure, cardiogenic shock, and death, was observed in patients with lower vitamin D levels.
- Severe vitamin D deficiency (<10 ng/ml) was associated with a 94.4% adverse event rate.
- Multivariate analysis confirmed vitamin D as an independent predictor of in-hospital adverse cardiac events (p=0.001).
Conclusions:
- Low plasma vitamin D levels are a significant independent predictor of in-hospital adverse cardiac events in patients with acute MI.
- Vitamin D status should be considered in the risk assessment and management of acute MI patients.
- Further research may explore therapeutic interventions to optimize vitamin D levels in this population.
Abstract:
Acute myocardial infarction has many risk factors and etiologies. Different factors are responsible for adverse in-hospital outcome after acute MI. Status of plasma vitamin D level has been found to be a good predictor of future adverse cardiovascular outcomes in patients with acute MI. Plasma vitamin D level has been considered as a potential marker for identifying individuals under risk of CAD and associated events. This study was done to investigate the role of plasma vitamin D level in predicting in-hospital adverse cardiac events in patients with acute MI. This cross sectional descriptive type of study was conducted in the cardiology department of Mymensingh Medical College Hospital, Mymensingh, Bangladesh from October 2017 to March 2019. Total 257 patients of first attack of acute MI were included considering inclusion and exclusion criteria. Fasting blood samples were analyzed for plasma vitamin D level. Sample population were grouped at first into two, normal and low vitamin D level, taking 30ng/ml as cut-off value, low vitamin D level is further subdivided into insufficiency (21-29ng/ml), deficiency (10-20ng/ml) and severe deficiency (<10ng/ml). Adverse in-hospital cardiac outcomes were observed. In-hospital adverse outcomes occurred in 42.9% patients having normal vitamin D level (>30ng/ml), 66.2% of patients having vitamin D insufficiency (21-29ng/ml), 78.2% of patients having vitamin D deficiency (10-20ng/ml) and 94.4% patients having severe vitamin D deficiency (<10ng/ml), which was statistically significant (p<0.05). Heart failure (30.3%, 47.7%, 63.6% and 77.8%, p<0.05), cardiogenic shock (12.6%, 27.7%, 34.5% and 33.3%, p<0.05), Arrhythmias (14.3%, 21.5%, 23.6% and 22.2%, p>0.05), death (2.5%, 0%, 3.6% and 11.1%, p>0.05) occurred more in low vitamin D groups. Mean vitamin D level was significantly different between Group I and Group II (42.59±10.08 vs. 18.64±6.54, p<0.0001). Multivariate regression analysis showed vitamin D is an independent predictor of in-hospital adverse cardiac events (p=0.001). Age (p=0.001) and obesity (p=0.048) were also other predictors of in-hospital adverse cardiac events. Low plasma vitamin D level is an important predictor for in-hospital adverse cardiac events in patients hospitalized with first attack of acute MI.
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