Iranian Heart Journal

Iranian Heart Journal

Prevalence of Vitamin D Deficiency in Patients With Acute Coronary Syndrome

Document Type : Original Article

Authors
Inas Deraz
Mai mohamed Salama
Dina abdelsalam Maria
Cardiology Department, Tanta University, Tanta, Egypt.
Abstract
Background: Vitamin D receptors are present in many tissues throughout the body, including vascular smooth muscle, endothelium, and cardiomyocytes. Therefore, vitamin D deficiency may adversely affect the cardiovascular system.
We aimed to measure the prevalence of vitamin D3 deficiency among patients with acute coronary syndrome (ACS) and to determine the relationship between this deficiency and other risk factors.
 
Methods: Serum vitamin D3 levels were measured in 200 patients with ACS, and its role in this patient group was evaluated through a cross-sectional study.
 
Results: The mean age of all patients was 53.4 ± 9.6 years, and the mean age of those with vitamin D3 deficiency was also 53.4 ± 9.6 years. Among the patients, 56% were male, 59.5% were smokers, 67.5% were hypertensive, 57.5% were diabetic, 50% had high total cholesterol, 57.5% had low HDL levels, 60% had high LDL levels, and 70.5% had high triglyceride levels. The mean vitamin D3 level for all patients was 20.8 ± 9.5 ng/dL. Among these patients, 10% had sufficient vitamin D3 levels, 22% had insufficient levels, and 68% were deficient.
 
Conclusions: Vitamin D3 deficiency was present in 68% of patients with ACS, indicating its prevalence in this patient population. Age, hypertension, and high triglyceride levels were statistically associated with vitamin D3 deficiency (OR 0.543, OR 0.582, and OR 0.618, respectively; P = 0.001, P = 0.001, and P = 0.001, respectively). (Iranian Heart Journal 2025; 26(2): 33-38)
Keywords
Acute coronary syndrome
Vitamin D3 deficiency
ischemic heart disease
  1. Zittermann A, Schleithoff SS, Koerfer R. Putting cardiovascular disease and vitamin D insufficiency into perspective. Br J Nutr 2005; 94: 483-92.
  2. Holick MF. Vitamin D deficiency. N Engl J Med 2007; 357: 266-81.
  3. Holick MF, Binkley NC, Bischoff-Ferrari HA, et al. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2011; 96: 1911-30.
  4. Li YC, Kong J, Wei M, Chen ZF, Liu SQ, Cao LP. 1,25-Dihydroxyvitamin D(3) is a negative endocrine regulator of the emode-angiotensin system. J Clin Invest 2002; 110: 229-38.
  5. Brewer LC, Michos ED, Reis JP. Vitamin D in atherosclerosis, vascular disease, and endothelial function. Curr Drug Targets 2011; 12: 54-60.
  6. Pilz S, Tomaschitz A, Drechsler C, Dekker JM, März W. Vitamin D deficiency and myocardial diseases. Mol Nutr Food Res 2010; 54: 1103-13.
  7. Chen S, Glenn DJ, Ni W, et al. Expression of the vitamin D receptor is increased in the hypertrophic heart. Hypertension 2008; 52: 1106-12.
  8. Somjen D, Weisman Y, Kohen F, et al. 25-hydroxyvitamin D3-1alpha-hydroxylase is expressed in human vascular smooth muscle cells and is upregulated by parathyroid hormone and estrogenic compounds. Circulation 2005; 111: 1666-71.
  9. Xiang W, Kong J, Chen S, et al. Cardiac hypertrophy in vitamin D receptor knockout mice: role of the systemic and cardiac emode-angiotensin systems. Am J Physiol Endocrinol Metab 2005; 288: 125-32.
  10. Zhou C, Lu F, Cao K, Xu D, Goltzman D, Miao D. Calcium- independent and 1,25(OH2)D3-dependent regulation of the emode-angiotensin system in 1a-hydroxylase knockout mice. Kidney Int 2008; 74: 170-9.
  11. Kassi E, Adamopoulos C, Basdra EK, Papavassiliou AG. Role of vitamin D in atherosclerosis. Circulation 2013; 128: 2517-31.
  12. Martins D, Wolf M, Pan D, et al. Prevalence of cardiovascular risk factors and the serum levels of 25-hydroxyvitamin D in the United States: data from the Third National Health and Nutrition Examination Survey. Arch Intern Med 2007; 167: 1159-65.
  13. Thacher TD, Clarke BL. Vitamin D insufficiency. Mayo Clin Proc 2011; 86: 50-60.
  14. Ferrario CM, Strawn WB. Role of the renin angiotensin- aldosterone system and proinflammatory mediators in cardiovascular disease. Am J Cardiol 2006; 98: 121-8.
  15. Gagnon C, Lu ZX, Magliano DJ, et al. Low serum 25-hydroxyvitamin D is associated with increased risk of the development of the metabolic syndrome at five years: results from a national, population-based prospective study. J Clin Endocrinol Metab 2012; 97: 1953-61.
  16. Pittas AG, Lau J, Hu FB, Dawson-Hughes B. The role of vitamin D and calcium in type 2 diabetes. A systematic review and metaanalysis. J Clin Endocrinol Metab 2007; 92: 2017-29
  17. Lamendola CA, Ariel D, Feldman D, Reaven GM. Relations between obesity, insulin resistance, and 25-hydroxyvitamin D. Am J Clin Nutr 2012; 95: 1055-105.
  18. Pilz S, Tomaschitz A, Drechsler C et al. (2010): Vitamin D deficiency and myocardial diseases. Mol. Nutr. Food Res., 54:1103-1113.
  19. James L, Vacek S, Reddy V et al. (2021): Vitamin D Deficiency and Supplementation and Relation to Cardiovascular Health. The American Journal of Cardiology, 109 (3): 359-363.
  20. Bordelon P, Ghetu M, Langan R et al. (2009): Recognition and management of vitamin D deficiency. Am Fam Physician, 80(8):841-846.
  21. Bhambhani G, Bhambhani R, Thakor N (2015): Lipid profile of patients with diabetes mellitus: a cross-sectional study. International Journal of Research in Medical Sciences, 3 (11): 3292-3295.
  22. Helvaci M, Kaya H, Gundogdu M (2010): Gender differences in coronary heart disease in Turkey. Pakistan Journal of Medical Sciences, 26 (3): 667-672.
  23. Kl Chul sung,Yoosoo Chang,Seungho Rau et al(2016):High levels of serum vitamin D are associated with decreased risk of metabolic diseases in both men and women, but an increased risk for coronary artery calcification in Korean men. Cardiovascular diabetology 2016(10):15-112
  24. Amen S (2020): High prevalence of vitamin D deficiency in patients with acute myocardial infarction: An Iraqi single-center study. Medical journal of Babylon, 17(4): 358-362.
  25. Jarrah M, Mhaidat N, Alzoubi K et al. (2018): The association between the serum level of vitamin D and ischemic heart disease: a study from Jordan. Vasc Health Risk Manag., 14: 119-127.
  26. Karur S, Veerappa V, Nanjappa M (2014): Study of vitamin D deficiency prevalence in acute myocardial infarction. Int. J. Cardiol. Heart Vessel, 3:57-59.
  27. Ali Haleem Jasin,Besmah Mohammed Ali,Najah Salman Abd, Ziyad Hzim Ibrahim(October 2022): Ischemic heart diseases and vitamin D3 deficiency, Baghdad,Iraq. The Egyptian Journal of Hospital Medicine 89(2):7517-7521.
  28. Wasson L, Shimbo D, Rubin M et al. (2011): Is vitamin D deficiency a risk factor for ischemic heart disease in patients with established cardiovascular disease? 10-year follow-up of the Nova Scotia Health Survey. International Journal of Cardiology, 148(3): 387-389.
  29. Siadat Z, Kiani K, Sadeghi M et al. (2012): Association of vitamin D deficiency and coronary artery disease with cardiovascular risk factors. Journal of Research in Medical Sciences, 17(11): 1052-1055.
  30. Ewelina A. Dziedzic, Jakub S. Gąsior et al.(2019): Vitamin D level is associated with severity of coronary artery atherosclerosis and incidence of acute coronary syndromes in non-diabetic cardiac patients.Archives of Medical Science (AMS) 15(2): 359–368.
Iranian Heart Journal
Volume 26, Issue 2
Spring 2025
Pages 33-38