Association of Serum Vitamin D Levels and Ventricular Dysfunction Among Patients With Acute ST-Segment Elevation...

Background Vitamin D deficiency is common in acute coronary syndromes and has been implicated in inflammation, myocardial injury, and adverse ventricular remodeling. However, evidence linking serum 25-hydroxyvitamin D (25(OH)D) levels with early ventricular dysfunction in acute ST-segment elevation myocardial infarction (STEMI) remains limited. This study evaluated the association between serum vitamin D status and left ventricular (LV) systolic dysfunction during the index hospitalization for STEMI. Methods This hospital-based analytical cross-sectional study included 150 consecutive adults with acute STEMI. Serum 25(OH)D was measured within 24 hours of admission, and patients were categorized as deficient (<20 ng/mL), insufficient (20-29 ng/mL), or normal (≥30 ng/mL). Transthoracic echocardiography was performed within 48-72 hours, and LV systolic dysfunction was defined as LV ejection fraction (LVEF) <50%. Group comparisons were performed using ANOVA and chi-square tests. Pearson correlation assessed associations between 25(OH)D and echocardiographic/inflammatory indices. Multivariable logistic regression identified independent variables associated with LV systolic dysfunction. Results Vitamin D status distribution was: insufficient 46.7% (n=70), normal 33.3% (n=50), and deficient 20.0% (n=30). Mean LVEF differed significantly across groups (normal 54.0 ± 6.0%, insufficient 51.6 ± 6.8%, deficient 44.8 ± 7.9%; p<0.001). LV systolic dysfunction occurred in 12/50 (24.0%) normal, 24/70 (34.3%) insufficient, and 30/30 (100.0%) deficient patients (p<0.001). Serum 25(OH)D correlated positively with LVEF (r=0.62; p<0.001) and inversely with Wall Motion Score Index (WMSI) (r=-0.58; p<0.001) and high-sensitivity C-reactive protein (hs-CRP) (r=-0.52; p<0.001). On multivariable analysis, vitamin D deficiency was independently associated with LV dysfunction (adjusted OR (aOR) 6.20; 95%CI 2.35-16.36; p<0.001), along with diabetes mellitus (aOR 2.85; 95%CI 1.36-5.94; p=0.005), anterior wall MI (aOR 4.10; 95%CI 1.88-8.93; p<0.001), and hs-CRP >10 mg/L (aOR 3.05; 95%CI 1.45-6.42; p=0.003). Conclusion Vitamin D deficiency was strongly associated with impaired early ventricular function and higher inflammatory burden in acute STEMI and showed an independent association with LV systolic dysfunction. Measurement of serum 25(OH)D may aid early risk stratification in STEMI.