.: ORİJİNAL ARAŞTIRMA
The Effect of Vitamin D Deficiency on the Risk and Time of Stent Restenosis After Percutaneous Coronary Angioplasty: Case-Control Study
Vitamin D Eksikliğinin Perkütan Transluminal Koroner Anjiyoplasti Sonrası Stent Restenoz Riski ve Zamanı Üzerine Etkisi: Olgu-Kontrol Çalışması
Turkiye Klinikleri J Cardiovasc Sci. 2021;33(3):135-41
doi: 10.5336/cardiosci.2021-84366
Makale Dili: EN
Tam Metin
ABSTRACT
Objective: Many studies have emphasized the role of inflammation in the development of stent restenosis after percutaneous transluminal coronary angioplasty (PTCA). Vitamin D plays an important role in the modulation of the inflammatory system. Recent studies suggest that vitamin D deficiency is associated with an increased risk of cardiovascular disease. The aim of this study was to investigate the association between vitamin D levels and the development of stent restenosis and the time course of stent restenosis after PTCA. Material and Methods: Fifty-eight patients (Group 1) were consecutively selected among patients admitted to Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital with angina pectoris who developed stent restenosis following PTCA. The control group patients (Group 2) had no stent restenosis following PTCA. Results: The 25(OH) D values were lower in patients with stent restenosis. The difference was significant (11.2 ng/mL vs. 13.8 ng/mL, p=0.02). The risk of restenosis increased 3.4 times when vitamin D level was below 11.3 ng/mL (area under the curve=0.651, 95% confidence interval 0.529-0.773, p=0.02). Also, as time elapsed after PTCA, there was a statistically insignificant weak negative correlation between vitamin D and risk and the time course of stent restenosis (r=-0.181, p=0.219). Conclusion: These findings indicate that lower serum vitamin D levels increase the risk of stent restenosis following coronary interventions. Vitamin D may be a marker for predicting stent restenosis. The already increased risk of restenosis may augment over time as patients' vitamin D levels remain low.
Keywords: Vitamin D; stent restenosis
Objective: Many studies have emphasized the role of inflammation in the development of stent restenosis after percutaneous transluminal coronary angioplasty (PTCA). Vitamin D plays an important role in the modulation of the inflammatory system. Recent studies suggest that vitamin D deficiency is associated with an increased risk of cardiovascular disease. The aim of this study was to investigate the association between vitamin D levels and the development of stent restenosis and the time course of stent restenosis after PTCA. Material and Methods: Fifty-eight patients (Group 1) were consecutively selected among patients admitted to Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital with angina pectoris who developed stent restenosis following PTCA. The control group patients (Group 2) had no stent restenosis following PTCA. Results: The 25(OH) D values were lower in patients with stent restenosis. The difference was significant (11.2 ng/mL vs. 13.8 ng/mL, p=0.02). The risk of restenosis increased 3.4 times when vitamin D level was below 11.3 ng/mL (area under the curve=0.651, 95% confidence interval 0.529-0.773, p=0.02). Also, as time elapsed after PTCA, there was a statistically insignificant weak negative correlation between vitamin D and risk and the time course of stent restenosis (r=-0.181, p=0.219). Conclusion: These findings indicate that lower serum vitamin D levels increase the risk of stent restenosis following coronary interventions. Vitamin D may be a marker for predicting stent restenosis. The already increased risk of restenosis may augment over time as patients' vitamin D levels remain low.
Keywords: Vitamin D; stent restenosis
ÖZET
Amaç: Birçok çalışma, perkütan transluminal koroner anjiyoplasti (PTKA) sonrası restenoz gelişiminde inflamasyonun rolünü vurgulamıştır. Vitamin D'nin, inflamatuar sistemin düzenlenmesinde önemli bir role sahip olduğu bilinmektedir. Son çalışmalar, vitamin D eksikliğinin kardiyovasküler riske sebep olduğunu göstermiştir. Bu çalışmanın amacı, vitamin D'nin PTKA sonrası restenoz gelişimi ve restenoz gelişim süresine etkisini araştırmaktır. Gereç ve Yöntemler: Dr. Siyami Ersek Göğüs Kalp ve Damar Cerrahisi Eğitim Ve Araştırma Hastanesine anjina pektoris ile başvuran, PTKA sonrası stent restenozu gelişen hastalardan ardışık 58 hasta seçilmiştir (Grup 1). Kontrol grubu (Grup 2), PTKA sonrası stent restenozu gelişmeyen hastalardır. Bulgular: 25 OH D düzeyleri, stent restenozlu hastalarda düşük bulunmuştur. Fark anlamlıydı (11,2 ng/mL vs. 13,8 ng/mL, p=0,02). D vitamini düzeyi, 11,3 ng/mL'nin altına indiğinde restenoz riski 3,4 kat artmıştır (eğrinin altındaki alan=0,651; %95 güven aralığı 0,529-0,773; p=0,02). Ayrıca PTKA sonrası zaman ilerledikçe, D vitamini ile restenoz risk ve gelişme zamanı arasında istatistiksel olarak anlamsız zayıf bir negatif korelasyon izlendi (r=-0,181; p=0,219). Sonuç: Bu bulgular, düşük D vitamini düzeylerinin PTKA sonrası stent restenoz riskini artırdığını göstermektedir. Vitamin D, stent restenozunu tahmin etmede bir gösterge olabilir. Hastaların D vitamini düzeyi düşük kaldığında, zaten artmış olan restenoz riski zamanla artabilir.
Anahtar Kelimeler: Vitamin D; stent restenozu
Amaç: Birçok çalışma, perkütan transluminal koroner anjiyoplasti (PTKA) sonrası restenoz gelişiminde inflamasyonun rolünü vurgulamıştır. Vitamin D'nin, inflamatuar sistemin düzenlenmesinde önemli bir role sahip olduğu bilinmektedir. Son çalışmalar, vitamin D eksikliğinin kardiyovasküler riske sebep olduğunu göstermiştir. Bu çalışmanın amacı, vitamin D'nin PTKA sonrası restenoz gelişimi ve restenoz gelişim süresine etkisini araştırmaktır. Gereç ve Yöntemler: Dr. Siyami Ersek Göğüs Kalp ve Damar Cerrahisi Eğitim Ve Araştırma Hastanesine anjina pektoris ile başvuran, PTKA sonrası stent restenozu gelişen hastalardan ardışık 58 hasta seçilmiştir (Grup 1). Kontrol grubu (Grup 2), PTKA sonrası stent restenozu gelişmeyen hastalardır. Bulgular: 25 OH D düzeyleri, stent restenozlu hastalarda düşük bulunmuştur. Fark anlamlıydı (11,2 ng/mL vs. 13,8 ng/mL, p=0,02). D vitamini düzeyi, 11,3 ng/mL'nin altına indiğinde restenoz riski 3,4 kat artmıştır (eğrinin altındaki alan=0,651; %95 güven aralığı 0,529-0,773; p=0,02). Ayrıca PTKA sonrası zaman ilerledikçe, D vitamini ile restenoz risk ve gelişme zamanı arasında istatistiksel olarak anlamsız zayıf bir negatif korelasyon izlendi (r=-0,181; p=0,219). Sonuç: Bu bulgular, düşük D vitamini düzeylerinin PTKA sonrası stent restenoz riskini artırdığını göstermektedir. Vitamin D, stent restenozunu tahmin etmede bir gösterge olabilir. Hastaların D vitamini düzeyi düşük kaldığında, zaten artmış olan restenoz riski zamanla artabilir.
Anahtar Kelimeler: Vitamin D; stent restenozu
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