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Clinical Trial
. 2019 Jun 12;14(6):e0217476.
doi: 10.1371/journal.pone.0217476. eCollection 2019.

The association between vitamin D status and clinical events in high-risk older patients with non-ST elevation acute coronary syndrome undergoing invasive management

Benjamin Beska  1   2 , Danny Chan  1   2 , Sophie Gu  1   2 , Weiliang Qiu  3 , Helen Mossop  4 , Dermot Neely  5 , Vijay Kunadian  1   2
Affiliations
Clinical Trial

The association between vitamin D status and clinical events in high-risk older patients with non-ST elevation acute coronary syndrome undergoing invasive management

Benjamin Beska et al. PLoS One. .

Abstract

There is a higher incidence of vitamin D deficiency in older adults. This may play a plausible mechanistic role in the occurrence of increased adverse events after non-ST elevation acute coronary syndrome (NSTEACS). This study investigated whether total vitamin D levels at the time of presentation predicted adverse outcomes in older adults undergoing invasive management of NSTEACS. Of the 629 patients screened, 300 high-risk older adults with NSTEACS managed by an invasive strategy were recruited. Serum total 25-hydroxyvitamin D was measured at index presentation. The primary outcome was defined as 1-year composite of all-cause mortality, acute coronary syndrome (ACS), unplanned repeat revascularisation, significant bleeding or stroke. Mean age was 80.5±4.8 years (61.9% male). Median vitamin D level was 29.5nmol/L [interquartile range IQR 16.0-53.0 nmol/L] and was split equally by the median for analysis forming two groups: high (median vitamin D 53.0 nmol/L [IQR 40.0-75.0]) and low (16.0 nmol/L [11.0-23.0]). The primary outcome occurred in 76 patients (25.9%); 32 (21.9%) in the low group and 44 (29.9%) in the high group, p = 0.12. Multivariable analyses showed no significant difference in the primary composite outcome at 1 year between the low and high group of baseline serum vitamin D (Hazard Ratio 1.20 [95% Confidence Interval 0.72-2.0], p = 0.48). Serum total vitamin D, measured at the time of angiography, was not associated with adverse outcomes at one year in this high-risk older cohort of patients with NSTEACS undergoing invasive management.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow diagram for the ICON-1 vitamin D biomarker sub-study.
Fig 2
Fig 2. Cumulative event-free survival from incidence of the cumulative primary composite endpoint at 1 year.
See this image and copyright information in PMC

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References

    1. Finegold JA, Asaria P, Francis DP. Mortality from ischaemic heart disease by country, region, and age: statistics from World Health Organisation and United Nations. Int J Cardiol. 2013;168(2):934–45. Epub 2012/12/12. 10.1016/j.ijcard.2012.10.046 - DOI - PMC - PubMed
    1. Avezum A, Makdisse M, Spencer F, Gore JM, Fox KA, Montalescot G, et al. Impact of age on management and outcome of acute coronary syndrome: observations from the Global Registry of Acute Coronary Events (GRACE). Am Heart J. 2005;149(1):67–73. 10.1016/j.ahj.2004.06.003 . - DOI - PubMed
    1. Gale CP, Cattle BA, Woolston A, Baxter PD, West TH, Simms AD, et al. Resolving inequalities in care? Reduced mortality in the elderly after acute coronary syndromes. The Myocardial Ischaemia National Audit Project 2003–2010. European heart journal. 2012;33(5):630–9. Epub 2011/10/20. 10.1093/eurheartj/ehr381 . - DOI - PubMed
    1. Lee PY, Alexander KP, Hammill BG, Pasquali SK, Peterson ED. Representation of elderly persons and women in published randomized trials of acute coronary syndromes. Jama. 2001;286(6):708–13. Epub 2001/08/10. . - PubMed
    1. Dodd KS, Saczynski JS, Zhao Y, Goldberg RJ, Gurwitz JH. Exclusion of older adults and women from recent trials of acute coronary syndromes. Journal of the American Geriatrics Society. 2011;59(3):506–11. Epub 2011/03/03. 10.1111/j.1532-5415.2010.03305.x ; PubMed Central PMCID: PMCPmc3377382. - DOI - PMC - PubMed

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