Vitamin D deficiency and degree of coronary artery luminal stenosis in women undergoing coronary angiography: a prospective observational study

Abstract

Background and aims: Low serum 25-OH D levels are associated with increased cardiovascular morbidity and mortality. Recent studies have linked 25-OH D deficiency with the presence of CAD. Women, especially post-menopausal, tend to suffer from accelerated atherosclerosis, along with vitamin D deficiency. In the present study we sought to investigate whether there is a direct association of coronary artery luminal stenosis with 25-OH D deficiency in women.

Patients and methods: We enrolled women aged >40 who were scheduled to undergo elective coronary angiography between 3/2011 and 10/2016 in a prospective observational study.

Results: We included a total of 105 women. Patients had hypertension (73%), hyperlipidemia (54%), diabetes (29%), smoking (31%), family history of CAD (62%), and known CAD (21%). Median 25-OH D levels were 15.8 ng/mL (range, 3.9-79). Patients had left-anterior descending (31%), left circumflex (22%), and right coronary artery disease (26%); 27% had 2-vessel and 11% had 3-vessel disease. There was a significant inverse correlation between 25-OH D levels and the degree of maximum luminal stenosis. The burden of CAD increased across categories of worsening 25-OH D deficiency.

Conclusions: Vitamin D deficiency is associated with the degree of luminal stenosis and burden of CAD in women undergoing coronary angiography. Future studies should investigate if the repletion of 25-OH D impacts the progression of CAD and cardiovascular mortality.

Keywords: 25-OH D; coronary artery disease; vitamin D; women.

Figure 1

Distribution of patients with >50% coronary artery stenosis in 25-OH D deficient, insufficient and sufficient patients.