Vitamin-D Levels of Patients with ST-elevation Myocardial Infarction and Association with In-hospital Prognosis: An Exploratory Observational Study in Southern India

Abstract

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 ECLIA (Enhanced Chemiluminiscence Immunoassay) 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.

Keywords

• acute coronary syndrome
• cardiac failure
• in-hospital
• liver function tests