title: Markers of bone metabolism in premature myocardial infarction (≤ 40 years of age).
abstract: BACKGROUND
  Acute myocardial infarction (AMI) at young age is a rare disease with a poor prognosis. Bone metabolism parameters such as 1,25 (OH)₂ vitamin D₃, 25 (OH) vitamin D₃ and osteocalcin have been recently implicated in the development of coronary heart disease (CHD). We evaluated the role of these serum markers in a study population of very young AMI survivors (≤ 40 years).
  
  
  RESULTS
  We prospectively enrolled 302 subjects into our multi-center case control study, including 102 young myocardial infarction patients (≤ 40 years) and 200 control subjects who were frequency-matched on gender and age in an approximate 2:1 ratio per case patient. In the adjusted logistic regression analysis, we used baseline laboratory measurements for the first analysis (acute phase analysis) and measurements from one-year follow-up visits (stable phase analysis). In both, elevated levels of 25 (OH) vitamin D₃ (acute phase: OR per IQR 2.02, 95% CI 1.13-3.58, p = 0.017; stable phase: OR 4.07, 95% CI 1.8-9.21, p = 0.001) and 1,25 (OH)₂ vitamin D₃ (acute phase: OR 2.82, 95% CI 1.7-4.7, p < 0.001; stable phase: OR 4.57, 95% CI 2.31-9.05, p < 0.001) were associated with premature AMI. Conversely, osteocalcin was inversely associated with premature myocardial infarction (acute phase: OR 0.53, 95% CI 0.28-1.03, p = 0.059; stable phase: OR 0.26, 95% CI 0.12-0.6, p < 0.001). The observed associations were independent of the acute phase of myocardial infarction.
  
  
  CONCLUSIONS
  In our study, elevated levels of 25 (OH) vitamin D₃ and 1,25 (OH)₂ vitamin D₃, as well as decreased levels of osteocalcin were associated with myocardial infarction in very young patients. The precise mechanism and implications of these findings will have to be elucidated in future studies.
authors.affiliation: Department of Cardiology, Vienna General Hospital/Medical University of Vienna, Austria.
authors.forename: Georg
authors.initials: G
authors.lastname: Goliasch
authors.forename: Hermann
authors.initials: H
authors.lastname: Blessberger
authors.forename: Danyel
authors.initials: D
authors.lastname: Azar
authors.forename: Georg
authors.initials: G
authors.lastname: Heinze
authors.forename: Johann
authors.initials: J
authors.lastname: Wojta
authors.forename: Christian
authors.initials: C
authors.lastname: Bieglmayer
authors.forename: Oswald
authors.initials: O
authors.lastname: Wagner
authors.forename: Martin
authors.initials: M
authors.lastname: Schillinger
authors.forename: Kurt
authors.initials: K
authors.lastname: Huber
authors.forename: Gerald
authors.initials: G
authors.lastname: Maurer
authors.forename: Martin
authors.initials: M
authors.lastname: Haas
authors.forename: Franz
authors.initials: F
authors.lastname: Wiesbauer
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D001842:Bone and Bones / Q000378:metabolism*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D009203:Myocardial Infarction / Q000097:blood*; D013997:Time Factors; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood
chemical_list: D015415:Biomarkers; D014807:Vitamin D; C104450:25-hydroxyvitamin D