title: Vitamin D deficiency, coronary artery disease, and endothelial dysfunction: observations from a coronary angiographic study in Indian patients.
abstract: METHODS
  Vitamin D deficiency has been linked to an increased risk of coronary artery disease (CAD) and cardiovascular (CV) death. Endothelial dysfunction plays an important role in pathogenesis of CAD and vitamin D deficiency is postulated to promote endothelial dysfunction. Despite rising trends of CAD in Asians, only limited data are available on the relationship between vitamin D, CAD, and endothelial dysfunction.
  
  
  RESULTS
  In a study of 100 patients undergoing coronary angiography, mean 25(OH)D level was 14.8 ± 9.1 ng/mL; vitamin D deficiency was present in 80% and only 7% had optimal 25(OH)D levels. Nearly one-third (36%) were severely deficient, with 25(OH)D levels <10 ng/mL. Those with vitamin D deficiency had significantly higher prevalence of double- or triple-vessel CAD (53% vs 38%), diffuse CAD (56% vs 34%), and higher number of coronary vessels involved as compared to those with higher 25(OH)D levels. Those with lower 25(OH)D levels had significantly lower brachial artery flow-mediated dilation (FMD; 4.57% vs 10.68%: P<.001) and significantly higher prevalence of impaired FMD (values <4.5%; 50.6% vs 7%; P<.002). A graded relationship between 25(OH)D levels and FMD was observed; impaired FMD was noted in 62.2%, 38.6%, and 13.3% in those with 25(OH)D levels <10 ng/mL, 10-20 ng/mL, and >20 ng/mL, respectively.
  
  
  CONCLUSIONS
  Indian patients with angiographically documented CAD frequently have vitamin D deficiency. Patients with lower 25(OH)D levels had higher prevalence of double- or triple-vessel CAD and diffuse CAD. Endothelial dysfunction as assessed by brachial artery FMD was also more frequently observed in those with low 25(OH)D levels.
authors.affiliation: Department of Cardiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Luck now 226014, India. akapoor65@gmail.com
authors.forename: Sanjeev Kumar
authors.initials: SK
authors.lastname: Syal
authors.forename: Aditya
authors.initials: A
authors.lastname: Kapoor
authors.forename: Eesh
authors.initials: E
authors.lastname: Bhatia
authors.forename: Archana
authors.initials: A
authors.lastname: Sinha
authors.forename: Sudeep
authors.initials: S
authors.lastname: Kumar
authors.forename: Satyendra
authors.initials: S
authors.lastname: Tewari
authors.forename: Naveen
authors.initials: N
authors.lastname: Garg
authors.forename: Pravin K
authors.initials: PK
authors.lastname: Goel
mesh_terms: D000368:Aged; D001916:Brachial Artery / Q000503:physiopathology; D017023:Coronary Angiography / Q000706:statistics & numerical data; D003324:Coronary Artery Disease / Q000097:blood / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000503:physiopathology; D004108:Dilatation, Pathologic / Q000209:etiology / Q000503:physiopathology; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012720:Severity of Illness Index; D014807:Vitamin D / Q000097:blood*; D014808:Vitamin D Deficiency / Q000097:blood / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology
chemical_list: D014807:Vitamin D