title: Serum 25(OH)D is a 2-year predictor of all-cause mortality, cardiac death and sudden cardiac death in chest pain patients from Northern Argentina.
abstract: BACKGROUND
  Several studies have shown an association between vitamin D deficiency and cardiovascular risk. Vitamin D status is assessed by determination of 25-hydroxyvitamin D [25(OH)D] in serum.
  
  
  METHODS
  We assessed the prognostic utility of 25(OH)D in 982 chest-pain patients with suspected acute coronary syndrome (ACS) from Salta, Northern Argentina. 2-year follow-up data including all-cause mortality, cardiac death and sudden cardiac death were analyzed in quartiles of 25(OH)D, applying univariate and multivariate analysis.
  
  
  RESULTS
  There were statistically significant changes in seasonal 25(OH)D levels. At follow-up, 119 patients had died. The mean 25(OH)D levels were significantly lower among patients dying than in long-term survivors, both in the total population and in patients with a troponin T (TnT) release (n = 388). When comparing 25(OH)D in the highest quartile to the lowest quartile in a multivariable Cox regression model for all-cause mortality, the hazard ratio (HR) for cardiac death and sudden cardiac death in the total population was 0.37 (95% CI, 0.19-0.73), p = 0.004, 0.23 (95% CI, 0.08-0.67), p = 0.007, and 0.32 (95% CI, 0.11-0.94), p = 0.038, respectively. In patients with TnT release, the respective HR was 0.24 (95% CI, 0.10-0.54), p = 0.001, 0.18 (95% CI, 0.05-0.60), p = 0.006 and 0.25 (95% CI, 0.07-0.89), p = 0.033. 25(OH)D had no prognostic value in patients with no TnT release.
  
  
  CONCLUSIONS
  Vitamin D was shown to be a useful biomarker for prediction of mortality when obtained at admission in chest pain patients with suspected ACS.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT01377402.
authors.affiliation: Department of Cardiology, Stavanger University Hospital, Stavanger, Norway.
authors.forename: Patrycja A
authors.initials: PA
authors.lastname: Naesgaard
authors.forename: Ricardo A
authors.initials: RA
authors.lastname: León De La Fuente
authors.forename: Stein Tore
authors.initials: ST
authors.lastname: Nilsen
authors.forename: Leik
authors.initials: L
authors.lastname: Woie
authors.forename: Torbjoern
authors.initials: T
authors.lastname: Aarsland
authors.forename: Cato
authors.initials: C
authors.lastname: Brede
authors.forename: Harry
authors.initials: H
authors.lastname: Staines
authors.forename: Dennis W T
authors.initials: DW
authors.lastname: Nilsen
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood / Q000401:mortality; D000368:Aged; D001118:Argentina / Q000453:epidemiology; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D002423:Cause of Death; D002637:Chest Pain / Q000097:blood* / Q000401:mortality*; D016757:Death, Sudden, Cardiac / Q000453:epidemiology*; D016002:Discriminant Analysis; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D016016:Proportional Hazards Models; D012372:ROC Curve; D018570:Risk Assessment; D020107:Troponin T / Q000097:blood; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood
chemical_list: D020107:Troponin T; D020097:Natriuretic Peptide, Brain; D014807:Vitamin D; D002097:C-Reactive Protein; C104450:25-hydroxyvitamin D