Muhammad I Ahmad1, Parag A Chevli1, Yabing Li2, Elsayed Z Soliman2,3. 1. Department of Internal Medicine, Section on Hospital Medicine, Wake Forest School of Medicine, Winston Salem, North Carolina. 2. Epidemiological Cardiology Research Center (EPICARE), Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston Salem, North Carolina. 3. Department of Internal Medicine, Section on Cardiology, Wake Forest School of Medicine, Winston Salem, North Carolina.
Abstract
BACKGROUND: Association of cardiovascular disease (CVD) with nontraditional risk factors such as vitamin D deficiency has been examined previously. An investigation of the association of vitamin D with subclinical myocardial injury (SC-MI) based on an electrocardiographic score is a simple, cost-effective and innovative way to explore this relationship. HYPOTHESIS: We hypothesize that low vitamin D levels will be associated with prevalent SC-MI independent of traditional CVD risk factors, lifestyle factors, and socioeconomic status. METHODS: This analysis included 6079 participants (58.3 ± 13.1 years; 54.1% women) without CVD from the third National Health and Nutrition Examination Survey. A multivariable logistic regression model was used to examine the association between vitamin D categories (<20, 20-29, and >30 ng/mL (reference) and cardiac injury score. RESULTS: There was an incremental increase in the prevalence of SC-MI across vitamin D categories with the highest prevalence in <20 ng/mL, followed by 20 to 29 ng/mL and then >30 ng/mL (trend P-value <0.0001). There was a statistically significant association between vitamin D deficiency (<20 ng/mL) and SC-MI (odds ratio [OR] (95% confidence interval [CI]): 1.27 (1.04-1.55), P = 0.04). This association was stronger in men than women (OR (95% CI): 1.74 (1.32-2.30) vs 0.94 (0.70-1.25) respectively; interaction P-value 0.002). CONCLUSIONS: Vitamin D deficiency is associated with SC-MI, especially in men. These findings may further highlight the role of nontraditional risk factors in the development of CVD. The value of vitamin D supplementation in the prevention of myocardial ischemia and injury may warrant investigation.
BACKGROUND: Association of cardiovascular disease (CVD) with nontraditional risk factors such as vitamin D deficiency has been examined previously. An investigation of the association of vitamin D with subclinical myocardial injury (SC-MI) based on an electrocardiographic score is a simple, cost-effective and innovative way to explore this relationship. HYPOTHESIS: We hypothesize that low vitamin D levels will be associated with prevalent SC-MI independent of traditional CVD risk factors, lifestyle factors, and socioeconomic status. METHODS: This analysis included 6079 participants (58.3 ± 13.1 years; 54.1% women) without CVD from the third National Health and Nutrition Examination Survey. A multivariable logistic regression model was used to examine the association between vitamin D categories (<20, 20-29, and >30 ng/mL (reference) and cardiac injury score. RESULTS: There was an incremental increase in the prevalence of SC-MI across vitamin D categories with the highest prevalence in <20 ng/mL, followed by 20 to 29 ng/mL and then >30 ng/mL (trend P-value <0.0001). There was a statistically significant association between vitamin D deficiency (<20 ng/mL) and SC-MI (odds ratio [OR] (95% confidence interval [CI]): 1.27 (1.04-1.55), P = 0.04). This association was stronger in men than women (OR (95% CI): 1.74 (1.32-2.30) vs 0.94 (0.70-1.25) respectively; interaction P-value 0.002). CONCLUSIONS:Vitamin D deficiency is associated with SC-MI, especially in men. These findings may further highlight the role of nontraditional risk factors in the development of CVD. The value of vitamin D supplementation in the prevention of myocardial ischemia and injury may warrant investigation.
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