Correlation of Plasma 25-Hydroxy-Vitamin D Level with Angiographic Severity in Coronary Artery Disease.

Abstract

Background: Coronary artery disease remains a major global health concern, ranking among the leading causes of mortality and contributing significantly to the global burden of disease measured in Disability-Adjusted Life Years (DALYs). In an article published in 2024, it was reported that there were 315 million prevalent cases of CAD worldwide. Vitamin D levels in the human body are influenced by a complex interplay of environmental, physiological, and health-related factors. Factors like geographic location, sunlight exposure are some of the important determinants as ultraviolet B (UVB) radiation from sunlight is required for cutaneous synthesis of vitamin D3. Along with this, skin pigmentation, dietary habits also play a significant role in the levels of Vitamin D in an individual. Additionally, comorbidities like obesity and chronic kidney disease can impair the synthesis of Vitamin D.

Objective: To study the correlation of plasma 25-hydroxy-vitamin D level with angiographic severity (Gensini score) in coronary artery disease.

Methodology: The present cross sectional observational study conducted at Department of Cardiology, Pradyumna Bal Memorial Hospital, KIMS, Bhubaneswar, Odisha. Results: The largest proportion of participants (33.3%) belonged to the 56–65 years age group, followed closely by the 66–75 years group, which constituted 31.7% of the total. The 35–45 and 46–55 age groups were less represented, making up 18.3% and 16.7% of the sample, respectively. The study population consisted of 60 participants, with a predominance of males. The Vitamin D levels of the 60 patients were categorized into six groups based on severity. Very severe Vitamin D deficiency (levels < 5 ng/ml) was observed in 1 patient (1.7%). Severe Vitamin D deficiency (5–10 ng/ml) was present in 18 patients (30.0%). Vitamin D levels between 11–30 ng/ml (Suboptimal level to Vitamin D deficiency) have the highest incidence of vessel involvement across all categories, particularly in double and triple vessel disease. In contrast, those with severe Vitamin D deficiency (≤10 ng/ml) (Severe to Very severe deficiency) also show a notable frequency of triple vessel involvement, indicating a potential link between deficiency and extensive coronary artery disease. On the other hand, individuals with sufficient Vitamin D levels (≥31 ng/ml) (Optimal level) exhibit minimal vessel involvement across all categories. This pattern suggests an inverse relationship between Vitamin D.

Conclusion: This study from Bhubaneshwar highlights a significant inverse association between serum vitamin D levels and the angiographic severity of coronary artery disease (CAD), as reflected by both the Gensini score and the degree of multivessel involvement.