Serum 25(OH)D is a 2-year predictor of all-cause mortality, cardiac death and sudden cardiac death in chest pain patients from Northern Argentina

PLoS One. 2012;7(9):e43228. doi: 10.1371/journal.pone.0043228. Epub 2012 Sep 6.

Abstract

Background: Several studies have shown an association between vitamin D deficiency and cardiovascular risk. Vitamin D status is assessed by determination of 25-hydroxyvitamin D [25(OH)D] in serum.

Methods: We assessed the prognostic utility of 25(OH)D in 982 chest-pain patients with suspected acute coronary syndrome (ACS) from Salta, Northern Argentina. 2-year follow-up data including all-cause mortality, cardiac death and sudden cardiac death were analyzed in quartiles of 25(OH)D, applying univariate and multivariate analysis.

Results: There were statistically significant changes in seasonal 25(OH)D levels. At follow-up, 119 patients had died. The mean 25(OH)D levels were significantly lower among patients dying than in long-term survivors, both in the total population and in patients with a troponin T (TnT) release (n = 388). When comparing 25(OH)D in the highest quartile to the lowest quartile in a multivariable Cox regression model for all-cause mortality, the hazard ratio (HR) for cardiac death and sudden cardiac death in the total population was 0.37 (95% CI, 0.19-0.73), p = 0.004, 0.23 (95% CI, 0.08-0.67), p = 0.007, and 0.32 (95% CI, 0.11-0.94), p = 0.038, respectively. In patients with TnT release, the respective HR was 0.24 (95% CI, 0.10-0.54), p = 0.001, 0.18 (95% CI, 0.05-0.60), p = 0.006 and 0.25 (95% CI, 0.07-0.89), p = 0.033. 25(OH)D had no prognostic value in patients with no TnT release.

Conclusion: Vitamin D was shown to be a useful biomarker for prediction of mortality when obtained at admission in chest pain patients with suspected ACS.

Trial registration: ClinicalTrials.gov NCT01377402.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Coronary Syndrome / blood
  • Acute Coronary Syndrome / mortality
  • Aged
  • Argentina / epidemiology
  • Body Mass Index
  • C-Reactive Protein / metabolism
  • Cause of Death
  • Chest Pain / blood*
  • Chest Pain / mortality*
  • Death, Sudden, Cardiac / epidemiology*
  • Discriminant Analysis
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Natriuretic Peptide, Brain / blood
  • Proportional Hazards Models
  • ROC Curve
  • Risk Assessment
  • Troponin T / blood
  • Vitamin D / analogs & derivatives*
  • Vitamin D / blood

Substances

  • Troponin T
  • Natriuretic Peptide, Brain
  • Vitamin D
  • C-Reactive Protein
  • 25-hydroxyvitamin D

Associated data

  • ClinicalTrials.gov/NCT01377402

Grant support

This work was funded by a research grant from Stavanger University Hospital to PAN. This funding agency had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.