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U-shaped relationship between vitamin D levels and long-term outcome in large cohort of survivors of acute myocardial infarction

Aleksova, A. et al.

International journal of cardiology. VOL 223, ; 2016, 962-966 -- Elsevier Science B.V., Amsterdam.

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  • Title:
    U-shaped relationship between vitamin D levels and long-term outcome in large cohort of survivors of acute myocardial infarction
  • Author: Aleksova, A.;
    Beltrami, A. P.;
    Belfiore, R.;
    Barbati, G.;
    Di Nucci, M.;
    Scapol, S.;
    De Paris, V.;
    Carriere, C.;
    Sinagra, G.
  • Found In: International journal of cardiology. VOL 223, ; 2016, 962-966
  • Journal Title: International journal of cardiology.
  • Subjects: Medicine; Biotechnology; Pharmaceutical Chemistry; LCC: RC; Dewey: 616.12
  • Publication Details: Elsevier Science B.V., Amsterdam.
  • Language: English
  • Abstract: AbstractBackgroundPrevious studies in the setting of patients with acute myocardial infarction (AMI) have demonstrated that hypovitaminosis D is associated with increased mortality risk during a follow-up whose median did not exceed two years.ObjectiveTo evaluate the impact of vitamin D levels on long-term mortality in patients with AMI.ResultsIn our study 477 patients with AMI were included. During a median follow-up period of 57 (IQR 53–64) months, 93 patients (20%) died. A non-linear U-shaped relationship between 25(OH)D levels and long-term mortality was observed; patients with vitamin D10ng/mL and >30ng/mL had higher mortality rate than those with intermediate values. After adjustment for differences in baseline features and treatment, it was confirmed that extreme values of vitamin D (10 or >30ng/mL) are independent predictors of mortality with HR of 3.02 (95% CI 1.78–5.11). Other independent predictors of outcome were age, NYHA class at discharge, treatment with ACE inhibitors and statins. The estimated time-dependent ROC curve of the multivariable model including vitamin D showed an AUC significantly higher than the model without vitamin D: AUC 0.82 (95% CI 0.76–0.87) vs. 0.77 (95% CI 0.71–0.83), p=0.005. Addition of vitamin D to the model that included all significant factors for mortality improved the prognostic accuracy as showed by the metrics of reclassification (NRI 0.34 (95% CI 0.14–0.48), p=0.003 and IDI 0.06 (95% CI 0.01–0.12, p=0.005 p=0.03).ConclusionsWe report a U-shaped relationship between vitamin D levels and long-term outcome of patients surviving AMI.
  • Identifier: Journal ISSN: 0167-5273
  • Publication Date: 2016
  • Physical Description: Physical
  • Shelfmark(s): 4542.158000
  • UIN: ETOCRN382095089

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