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Predictive value of 25-hydroxyvitamin D level in patients with coronary artery disease: A meta-analysis
Hailing Zhang1, Pei Wang2, Yu Jie2
1Center of Clinical Medical Research, The Affiliated Suqian First People's Hospital of Xuzhou Medical University, Suqian, China.
Insights
Low vitamin D levels in coronary artery disease (CAD) patients may predict adverse outcomes, including mortality and major adverse cardiovascular events (MACEs). This finding suggests vitamin D status is a valuable indicator in CAD patient management.
Area of Science:
- Cardiology
- Endocrinology
- Nutritional Science
Background:
- The predictive value of blood vitamin D levels in patients with coronary artery disease (CAD) remains debated.
- This meta-analysis investigates the association between 25-hydroxyvitamin D levels and adverse outcomes in CAD patients.
Approach:
- A systematic literature search was conducted on PubMed and Embase databases up to June 28, 2022.
- Included were cohort studies and post-hoc analyses of randomized trials assessing 25-hydroxyvitamin D's predictive value for cardiovascular mortality, all-cause mortality, and major adverse cardiovascular events (MACEs).
Key Points:
- The analysis encompassed 13 studies with 17,892 CAD patients.
- Meta-analysis revealed significantly increased risks for all-cause mortality (RR 1.60), cardiovascular mortality (RR 1.48), and MACEs (RR 1.33) in patients with lower vitamin D levels.
- Sensitivity analyses confirmed the reliability of these predictive values.
Conclusions:
- Low blood 25-hydroxyvitamin D levels are potentially independent predictors of mortality and MACEs in CAD patients.
- Baseline vitamin D status may offer valuable prognostic information for individuals with coronary artery disease.
Background:
A consensus has not been made about the predictive value of blood vitamin D level in patients with coronary artery disease (CAD). This meta-analysis aimed to assess the association between blood 25-hydroxyvitamin D level and adverse outcomes in patients with CAD.
Methods:
Two independent authors searched the articles indexed in PubMed and Embase databases until June 28, 2022. Cohort studies or post-hoc analysis randomized trials evaluating the value of 25-hydroxyvitamin D level in predicting cardiovascular or all-cause mortality, and major adverse cardiovascular events ([MACEs] including death, non-fatal myocardial infarction, heart failure, revascularization, stroke, etc.) were included.
Results:
The literature search identified 13 eligible studies for our analysis, including 17,892 patients with CAD. Meta-analysis showed that the pooled adjusted risk ratio (RR) was 1.60 (95% confidence intervals [CI] 1.35-1.89) for all-cause mortality, 1.48 (95% CI 1.28-1.71) for cardiovascular mortality, and 1.33 (95% CI 1.18-1.49) for MACEs. Leave-out one study sensitivity analysis suggested that the predictive values of blood 25-hydroxyvitamin D level were reliable.
Conclusions:
Low blood 25-hydroxyvitamin D level is possibly an independent predictor of cardiovascular or all-cause mortality and MACEs in patients with CAD. Baseline 25-hydroxyvitamin D level may provide useful information in CAD patients.
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