Vitamin D Predicts All-Cause and Cardiac Mortality in Females with Suspected Acute Coronary Syndrome : A Comparison with Brain Natriuretic Peptide and High-Sensitivity C-Reactive Protein

Abstract EN

Vitamin D may not only reflect disease but may also serve as a prognostic indicator.

Our aim was to assess the gender-specific utility of vitamin D measured as 25-hydroxy-vitamin D [25(OH)D] to predict all-cause and cardiac death in patients with suspected acute coronary syndrome (ACS) and to compare its prognostic utility to brain natriuretic peptide (BNP) and high-sensitivity C-reactive protein (hsCRP).

Blood samples were harvested on admission in 982 patients.

Forty percent were women (65.9 ± 12.6 years).

Mortality was evaluated in quartiles of 25(OH)D, BNP, and hsCRP, respectively, during a 5-year follow-up, applying univariate and multivariate analyses.

One hundred and seventy-three patients died; 78 were women.

In 92 patients (37 women), death was defined as cardiac.

In women, the univariate hazard ratio (HR) for total death of 25(OH)D in Quartile (Q) 2 versus Q1, Q3 versus Q1, and Q4 versus Q1 was 0.55 (95% CI 0.33–0.93), 0.29 (95% CI 0.15–0.55), and 0.13 (95% CI 0.06–0.32), respectively.

In females, it was an independent predictor of total and cardiac death, whereas BNP and hsCRP were less gender-specific.

No gender differences in 25(OH)D were noted in a reference material.

Accordingly, vitamin D independently predicts mortality in females with suspected ACS.