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Relationship between vitamin D and cholesterol levels in STEMI patients undergoing primary percutaneous coronary
Monica Verdoia1, Filippo Viglione2, Annalisa Boggio3
1Division of Cardiology, Ospedale degli Infermi, ASL Biella, Biella, Italy.
Insights
Low vitamin D levels in patients with ST-segment elevation myocardial infarction (STEMI) are linked to a more atherogenic lipid profile, independent of statin therapy. This highlights vitamin D
Area of Science:
- Cardiology
- Endocrinology
- Nutritional Science
Background:
- Growing interest in the relationship between vitamin D and metabolic health, particularly its influence on lipid profiles and lipid-lowering treatments.
- Previous research suggests vitamin D may play a role in cardiovascular health and lipid metabolism.
Purpose of the Study:
- To investigate the impact of vitamin D levels on cholesterol parameters in patients diagnosed with ST-segment elevation myocardial infarction (STEMI).
- To assess whether vitamin D status influences lipid profiles in patients undergoing primary percutaneous coronary intervention (PCI).
Main Methods:
- Retrospective analysis of 450 STEMI patients treated with primary PCI.
- Patients categorized into tertiles based on 25-hydroxyvitamin D [25(OH)D] levels measured at admission.
- Assessment of lipid parameters (total cholesterol, LDL-C, HDL-C) and correlation with vitamin D levels, considering factors like statin use.
Main Results:
- Lower vitamin D levels were associated with increased total and LDL cholesterol, and higher HDL cholesterol.
- Vitamin D deficiency independently predicted elevated LDL cholesterol or levels above target in STEMI patients.
- These associations persisted regardless of statin therapy, indicating a direct link between vitamin D status and atherogenic lipids.
Conclusions:
- Lower vitamin D levels are independently associated with a more atherogenic lipid profile in STEMI patients undergoing primary revascularization.
- The findings underscore the potential role of vitamin D in lipid management for cardiovascular patients.
- Further research is warranted to explore therapeutic implications of vitamin D supplementation in this population.
Background And Aims:
Special interest has been raised on vitamin D association with the metabolic profile, potentially interfering with lipid parameters and lipid-lowering therapies. The aim of the present study was to assess the impact of vitamin D on the cholesterol levels among patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary PCI.
Methods And Results:
A consecutive cohort of 450 patients admitted for STEMI treated with pPCI were retrospectively identified and divided according to tertiles values of 25(OH). The levels of 25(OH)D were assessed at admission by chemiluminescence immunoassay kit LIAISON®Vitamin D assay (Diasorin Inc). Lower vitamin D was associated to a higher use of diuretics (p = 0.03), lower prevalence of lesions on bifurcations (p = 0.001) and smaller diameter of the target coronary vessel (p = 0.03), but higher coronary calcifications (p = 0.007). Total and LDL cholesterol levels were significantly increased in patients with lower vitamin D (p = 0.05 and p = 0.005), inversely relating with total cholesterol (r = -0.09, p = 0.06) and LDL-C (r = -013, p = 0.007), and directly with HDL-C (r = 0.16, p = 0.001). Results were not affected by statin therapy, with a significant relationship being confirmed for atherogenic lipids, but not for HDL-C in statin treated patients. In fact, at multivariate analysis, vitamin D in lower tertiles emerged as an independent predictor of LDL-C elevated or above the target (adjusted OR [95%CI] = 2.6 [1.51-4.44], p = 0.001).
Conclusion:
The present study shows that among patients with STEMI undergoing primary revascularization, lower levels of vitamin D are independently associated with a more atherogenic lipid profile. Similar results were observed in statin treated or naïve patients.
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