Effect of calcifediol treatment on cardiovascular outcomes in patients with acute coronary syndrome and percutaneous revascularization

• Published in: Medicina clinica Vol. 151; no. 9; p. 345
• Main Authors: Navarro-Valverde, Cristina, Quesada-Gómez, Jose M, Pérez-Cano, Ramón, Fernández-Palacín, Ana, Pastor-Torres, Luis F
• Format: Journal Article
• Language: English; Spanish
• Published: Spain 09.11.2018
• Subjects: Revascularización coronaria percutánea; Parathormone; Vitamin D deficiency; 25(OH)D supplements; Non-ST-elevation acute coronary syndrome; Déficit vitamina D; Episodios cardiovasculares adversos mayores; Paratohormona; Mayor adverse cardiovascular events; Percutaneous coronary intervention; Suplementos 25(OH)D; Síndrome coronario agudo sin elevación de ST
• ISSN: 1578-8989
• DOI: 10.1016/j.medcli.2017.11.033

Vitamin D deficiency has been consistently linked with cardiovascular diseases. However, results of intervention studies are contradictory. The aim of this study was to evaluate the effect of treatment with calcifediol (25(OH)D ) on the cardiovascular system of patients with non-ST-elevation acute coronary syndrome after percutaneous coronary intervention. A prospective study assessing≥60-year-old patients with non-ST-elevation acute coronary syndrome, coronary artery disease and percutaneous revascularisation. We randomly assigned 41 patients (70.6±6.3 years) into 2 groups: Standard treatment+25(OH)D supplementation or standard treatment alone. Major adverse cardiovascular events (MACE) were evaluated at the conclusion of the 3-month follow-up period. 25(OH)D levels were analysed with regard to other relevant analytical variables and coronary disease extent. Basal levels of 25(OH)D≤50nmol/L were associated with multivessel coronary artery disease (RR: 2.6 [CI 95%:1.1-7.1], P=.027) and 25(OH)D≤50nmol/L+parathormone ≥65pg/mL levels correlated with increased risk for MACE (RR: 4 [CI 95%: 1.1-21.8], P=.04]. One MACE was detected in the supplemented group versus five in the control group (P=.66). Among patients with 25(OH)D levels≤50nmol/L at the end of the study, 28.6% had MACE versus 0% among patients with 25(OH)D>50nmol/L (RR: 1,4; P=.037). Vitamin D deficiency plus secondary hyperparathyroidism may be an effective predictor of MACE. A trend throughout the follow up period towards a reduction in MACE among patients supplemented with 25(OH)D was detected. 25(OH)D levels≤50nmol/L at the end of the intervention period were significantly associated with an increased number of MACE, hence, 25(OH)D level normalisation could improve cardiovascular health in addition to bone health.