Vitamin d predicts all-cause and cardiac mortality in females with suspected acute coronary syndrome: a comparison with brain natriuretic Peptide and high-sensitivity C-reactive protein

Patrycja A Naesgaard, Ricardo A León de la Fuente, Stein Tore Nilsen, Leik Woie, Torbjoern Aarsland, Harry Staines, Dennis W T Nilsen, Patrycja A Naesgaard, Ricardo A León de la Fuente, Stein Tore Nilsen, Leik Woie, Torbjoern Aarsland, Harry Staines, Dennis W T Nilsen

Abstract

Vitamin D may not only reflect disease but may also serve as a prognostic indicator. Our aim was to assess the gender-specific utility of vitamin D measured as 25-hydroxy-vitamin D [25(OH)D] to predict all-cause and cardiac death in patients with suspected acute coronary syndrome (ACS) and to compare its prognostic utility to brain natriuretic peptide (BNP) and high-sensitivity C-reactive protein (hsCRP). Blood samples were harvested on admission in 982 patients. Forty percent were women (65.9 ± 12.6 years). Mortality was evaluated in quartiles of 25(OH)D, BNP, and hsCRP, respectively, during a 5-year follow-up, applying univariate and multivariate analyses. One hundred and seventy-three patients died; 78 were women. In 92 patients (37 women), death was defined as cardiac. In women, the univariate hazard ratio (HR) for total death of 25(OH)D in Quartile (Q) 2 versus Q1, Q3 versus Q1, and Q4 versus Q1 was 0.55 (95% CI 0.33-0.93), 0.29 (95% CI 0.15-0.55), and 0.13 (95% CI 0.06-0.32), respectively. In females, it was an independent predictor of total and cardiac death, whereas BNP and hsCRP were less gender-specific. No gender differences in 25(OH)D were noted in a reference material. Accordingly, vitamin D independently predicts mortality in females with suspected ACS.

Figures

Figure 1
Figure 1
Kaplan-Meier plots for the cumulative risk of all-cause mortality in women in the 25(OH)D quartiles.
Figure 2
Figure 2
Receiver operating characteristic curves for 25(OH)D, BNP, and hsCRP for evaluation of all-cause mortality in the female patient population.
Figure 3
Figure 3
Kaplan-Meier plots for the cumulative risk of all-cause mortality in men in the 25(OH)D quartiles.
Figure 4
Figure 4
Receiver operating characteristic curves for 25(OH)D, BNP, and hsCRP for the evaluation of all-cause mortality in the male patient population.

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Source: PubMed

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