Subject(s)
Coronary Stenosis/blood , Myocardial Infarction/blood , Vitamin D/analogs & derivatives , Female , Humans , MaleABSTRACT
BACKGROUND: The study aimed to examine the relationship between vitamin D levels and the extent of coronary stenotic lesions in patients with ST-segment elevation myocardial infarction (STEMI). Experimental evidence points to the involvement of multiple factors in coronary plaque formation, including vitamin D. Little is known, however, about the association of vitamin D level with the intensity of atherosclerosis. METHODS: Serum concentrations of 25-hydroxyvitamin D [25(OH)D] were measured in 130 consecutive patients with the first acute STEMI treated with primary percutaneous coronary intervention. STEMI was the first symptom of coronary artery disease (CAD). The study population was divided into patients with single and multi-vessel CAD. The angiographic severityof CAD was also determined based on the Gensini score. RESULTS: The median 25(OH)D concentration was 11.12 ng/mL (25th and 75th percentile: 6.05; 17.12). Insufficient (20-30 ng/mL), deficient (10-20 ng/mL) and severely deficient(< 10 ng/mL) 25(OH)D levels were present in 18%, 35% and 45% of the individuals, respectively. Only 2 (2%) of patients had proper 25(OH)D levels (> 30 ng/mL). The 25(OH)D concentrations between patients with single- and multi-vessel CAD did not differ significantly (10.2 vs. 11.4 ng/mL, p = 0.62). There was no significant correlation between 25(OH)D levels and Gensini score (r = -0.0221, p = 0.81). CONCLUSIONS: The study demonstrated that vitamin D level is not associated with the severity of coronary lesions in patients with the first STEMI. A high prevalence of vitamin D deï¬ciency in these patients was confirmed.
Subject(s)
Coronary Stenosis/blood , Myocardial Infarction/blood , Vitamin D/analogs & derivatives , Aged , Biomarkers/blood , Coronary Angiography , Coronary Stenosis/complications , Coronary Stenosis/diagnosis , Electrocardiography , Female , Follow-Up Studies , Humans , Male , Middle Aged , Myocardial Infarction/diagnosis , Myocardial Infarction/etiology , Retrospective Studies , Risk Factors , Severity of Illness Index , Vitamin D/bloodABSTRACT
OBJECTIVE: Experimental and clinical studies have proven the neuroprotective effects of hypothermia in unconscious patients with spontaneous circulation after out-of-hospital cardiac arrest. Based on this evidence, recommendations have been made to incorporate mild therapeutic hypothermia into practice. ECG changes are well documented in people with incidental hypothermia but there are only few studies on ECG abnormalities in patients undergoing mild therapeutic hypothermia after cardiac arrest due to ST-elevation myocardial infarction. METHODS: Ten patients with ST-elevation myocardial infarction (STEMI) complicated by cardiac arrest and receiving mild therapeutic hypothermia (MTH) after return of spontaneous circulation and ten comparable patients but not receiving mild therapeutic hypothermia as a control group were incorporated into our prospective study. We analysed electrocardiographic (ECG) changes during hypothermia and its influence on ECG evolution in patients after STEMI. RESULTS: MTH was mainly associated with decrease of heart rate (P = 0.014) and QTc interval prolongation (P = 0.005). In 60% of patients the Osborn wave was registered. The presence of a new Q wave or new negative T wave in ECGs registered on the 3rd day of STEMI was comparable in the two groups. CONCLUSIONS: Although hypothermia is associated with typical ECG findings like Osborn wave, the electrocardiographic evolution of STEMI in patients receiving MTH is comparable with that in patients without it.
