title: Vitamin D levels do not predict cardiovascular events in statin-treated patients with stable coronary disease.
abstract: BACKGROUND
  This post hoc nested case-control analysis of the TNT study was designed to investigate whether baseline vitamin D level is a significant predictor of cardiovascular risk among statin-treated patients and whether changes in vitamin D after treatment with atorvastatin are associated with improved cardiovascular outcomes.
  
  
  METHODS
  A total of 10,001 patients with stable coronary heart disease were randomized to atorvastatin 80 or 10 mg for a median of 4.9 years. This analysis included 1,509 patients (497 with a subsequent cardiovascular event and 1,012 without an event) with vitamin D levels determined at baseline and 1 year. Event rates were analyzed by Cox proportional hazard model by baseline vitamin D levels, with vitamin D as a continuous variable, and with change in vitamin D level as the predictor.
  
  
  RESULTS
  Vitamin D deficiency (<15 ng/mL) or insufficiency (15- <30 ng/mL) was present in 108 (7.2%) of 1,509 and 625 (41.4%) of 1,509 of patients, whereas 46 (3.0%) of 1,509 had elevated vitamin D. There was no relationship between baseline vitamin D levels or change in vitamin D levels and cardiovascular events or mortality. Modeling of events with vitamin D as a continuous variable similarly showed no relationship of vitamin D to events. These findings held true after adjustment for seasonal variations in vitamin D and other confounders.
  
  
  CONCLUSIONS
  In statin-treated patients with stable coronary heart disease, vitamin D levels did not predict cardiovascular risk. Changes in plasma concentrations of vitamin D after 1 year of treatment made no contribution to the efficacy of atorvastatin therapy.
authors.affiliation: University of Alabama at Birmingham, 35294-0007, USA. vbittner@uab.edu
authors.forename: Vera
authors.initials: V
authors.lastname: Bittner
authors.forename: Nanette K
authors.initials: NK
authors.lastname: Wenger
authors.forename: David D
authors.initials: DD
authors.lastname: Waters
authors.forename: David A
authors.initials: DA
authors.lastname: DeMicco
authors.forename: Michael
authors.initials: M
authors.lastname: Messig
authors.forename: John C
authors.initials: JC
authors.lastname: LaRosa
mesh_terms: D000368:Aged; D000069059:Atorvastatin; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000401:mortality; D016022:Case-Control Studies; D015331:Cohort Studies; D003327:Coronary Disease / Q000097:blood / Q000188:drug therapy*; D004311:Double-Blind Method; D005260:Female; D006538:Heptanoic Acids / Q000008:administration & dosage*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011758:Pyrroles / Q000008:administration & dosage*; D012307:Risk Factors; D016896:Treatment Outcome; D014807:Vitamin D / Q000097:blood*; D014808:Vitamin D Deficiency / Q000453:epidemiology
chemical_list: D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011758:Pyrroles; D014807:Vitamin D; D000069059:Atorvastatin