Details

Autor(en) / Beteiligte

• Aleksova, Aneta
• Beltrami, Antonio Paolo
• Belfiore, Rita
• Barbati, Giulia
• Di Nucci, Milena
• Scapol, Sara
• De Paris, Valerio
• Carriere, Cosimo
• Sinagra, Gianfranco

Titel

U-Shaped Relationship Between Vitamin D Levels and Long-Term Outcome in Large Cohort of Survivors of Acute Myocardial Infarction

Ist Teil von

• International journal of cardiology, 2016-11, Vol.223, p.962-966

Ort / Verlag

Netherlands: Elsevier B.V

Erscheinungsjahr

2016

Quelle

ScienceDirect

Beschreibungen/Notizen

• Abstract Background Previous studies in the setting of patients with acute myocardial infarction (AMI) have demonstrated that hypovitaminosis D is associated with increased mortality risk during a follow-up whose median did not exceed two years. Objective To evaluate the impact of vitamin D levels on long-term mortality in patients with AMI. Results In our study 477 patients with AMI were included. During a median follow-up period of 57 (IQR 53–64) months, 93 patients (20%) died. A non-linear U-shaped relationship between 25(OH) D levels and long-term mortality was observed; patients with vitamin D < 10 ng/mL and > 30 ng/mL had higher mortality rate than those with intermediate values. After adjustment for differences in baseline features and treatment, it was confirmed that extreme values of vitamin D (< 10 or > 30 ng/ml) are independent predictors of mortality with HR of 3.02 (95%CI 1.78–5.11). Other independent predictors of outcome were age, NYHA class at discharge, treatment with ACE inhibitors and statins. The estimated time-dependent ROC curve of the multivariable model including Vitamin D showed an AUC significantly higher than the model without Vitamin D: AUC 0.82 (95% CI 0.76–0.87) vs. 0.77 (95% CI 0.71–0.83), p = 0.005. Addition of vitamin D to the model that included all significant factors for mortality improved the prognostic accuracy as showed by the metrics of reclassification (NRI 0.34 (95% CI 0.14–0.48), p = 0.003 and IDI 0.06 (95% CI 0.01–0.12, p = 0.005 p = 0.03). Conclusions We report a U-shaped relationship between Vitamin D levels and long-term outcome of patients surviving AMI.