Vitamin-D Levels of Patients with ST-elevation Myocardial Infarction and Association with In-hospital Prognosis: An Exploratory Observational Study in Southern India
Published: June 1, 2023 | DOI: https://doi.org/10.7860/JCDR/2023/60340.18118
Shilpa Avarebeel, Roshan Nazirudeen, Vinayarani Gowda, Mohan Goudar, MS Shwetha Shree
1. Associate Professor, Department of Geriatrics, JSS Medical College, Mysore, Karnataka, India.
2. Intern, Department of General Medicine, JSS Medical College, Mysore, Karnataka, India.
3. Clinical Research Officer, Centre for Clinical Research Excellence, JSS Academy of Higher Education and Research, JSS Hospital, Mysore, Karnataka, India.
4. Professor, Department of General Medicine, Mamatha Medical College, Mysore, Karnataka, India.
5. Clinical Research Assistant, Centre for Clinical Research Excellence, JSS Academy of Higher Education and Research, JSS Hospital, Mysore, Karnataka, India.
Correspondence
Dr. Shilpa Avarebeel,
Associate Professor, Department of Geriatrics, JSS Medical College, MG Road, Mysore-570015, Karnataka, India.
E-mail: shilpaavarebeel@gmail.com
Introduction: The role of vitamin-D in various diseases, including heart disease, has been a subject of interest in recent years. Many studies revealed low vitamin-D status in patients with Acute Coronary Syndrome (ACS). Studies have shown statistically significant low Vitamin-D levels in patients with Myocardial Infarction (MI) in recent years with some studies showing association of vitamin-D deficiency with worse outcome in patients with severe deficiency.
Aim: To determine serum vitamin-D levels in patients with acute ST-Elevation Myocardial Infarction (STEMI), and its association with in-hospital prognosis.
Materials and Methods: An exploratory observational study was conducted in 100 patients with STEMI consulting a General Medicine Department, JSS Hospital (Tertiary Healthcare Centre), Mysuru, Karnataka, India, from May 2015 to June 2016. The patients were followed-up for in-hospital prognosis. Serum vitamin-D was estimated by Enhanced Chemiluminiscence Immunoassay (ECLIA) method. Electrocardiogram (ECG), Echocardiogram (ECHO) and Coronary Angiogram (CAG) were done in all patients using standard procedures. In-hospital prognosis of the subjects with vitamin-D deficiency and those with normal vitamin-D levels were compared. Data was analysed using Statistical Package for the Social Sciences (SPSS) software version 21.0.
Results: Of total 100 patients, majority (n=59, 15.36%) were in the age group of 50-69 years and there were 81 males and 19 females. The results showed 72% of the subjects were deficient and 19% had insufficient vitamin-D levels, therefore, a total of 91% of the STEMI patients had abnormally low vitamin-D levels. Those with Diabetes Mellitus (DM) (n=52) and past Ischaemic Heart Disease (IHD) (n=9) had significantly low vitamin-D levels, suggesting that the association of vitamin-D deficiency with these risk factors may also contribute to the role of vitamin-D deficiency in STEMI. Among those with cardiac failure (44%), 86.3% had deficient and 11.6% had insufficient vitamin-D levels.
Conclusion: Vitamin-D deficiency was seen in majority of the STEMI patients. Significantly deficient level of vitamin-D was observed in STEMI patients who progressed to cardiac failure (44%) as a complication.
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