title: Vitamin d predicts all-cause and cardiac mortality in females with suspected acute coronary syndrome: a comparison with brain natriuretic Peptide and high-sensitivity C-reactive protein.
abstract: Vitamin D may not only reflect disease but may also serve as a prognostic indicator. Our aim was to assess the gender-specific utility of vitamin D measured as 25-hydroxy-vitamin D [25(OH)D] to predict all-cause and cardiac death in patients with suspected acute coronary syndrome (ACS) and to compare its prognostic utility to brain natriuretic peptide (BNP) and high-sensitivity C-reactive protein (hsCRP). Blood samples were harvested on admission in 982 patients. Forty percent were women (65.9 ± 12.6 years). Mortality was evaluated in quartiles of 25(OH)D, BNP, and hsCRP, respectively, during a 5-year follow-up, applying univariate and multivariate analyses. One hundred and seventy-three patients died; 78 were women. In 92 patients (37 women), death was defined as cardiac. In women, the univariate hazard ratio (HR) for total death of 25(OH)D in Quartile (Q) 2 versus Q1, Q3 versus Q1, and Q4 versus Q1 was 0.55 (95% CI 0.33-0.93), 0.29 (95% CI 0.15-0.55), and 0.13 (95% CI 0.06-0.32), respectively. In females, it was an independent predictor of total and cardiac death, whereas BNP and hsCRP were less gender-specific. No gender differences in 25(OH)D were noted in a reference material. Accordingly, vitamin D independently predicts mortality in females with suspected ACS.
authors.affiliation: Department of Cardiology, Stavanger University Hospital, 4068 Stavanger, Norway ; Institute of Medicine, University of Bergen, 5021 Bergen, Norway.
authors.forename: Patrycja A
authors.initials: PA
authors.lastname: Naesgaard
authors.affiliation: Department of Cardiology, Stavanger University Hospital, 4068 Stavanger, Norway ; Cardiology Research Institute, Catholic University of Salta, A4400ANG Salta, Argentina.
authors.forename: Ricardo A
authors.initials: RA
authors.lastname: León de la Fuente
authors.affiliation: Department of Research, Stavanger University Hospital, 4068 Stavanger, Norway.
authors.forename: Stein Tore
authors.initials: ST
authors.lastname: Nilsen
authors.affiliation: Department of Cardiology, Stavanger University Hospital, 4068 Stavanger, Norway ; Cardiology Research Institute, Catholic University of Salta, A4400ANG Salta, Argentina.
authors.forename: Leik
authors.initials: L
authors.lastname: Woie
authors.affiliation: Department of Research, Stavanger University Hospital, 4068 Stavanger, Norway.
authors.forename: Torbjoern
authors.initials: T
authors.lastname: Aarsland
authors.affiliation: Sigma Statistical Services, Balmullo KY16 0BJ, UK.
authors.forename: Harry
authors.initials: H
authors.lastname: Staines
authors.affiliation: Department of Cardiology, Stavanger University Hospital, 4068 Stavanger, Norway ; Cardiology Research Institute, Catholic University of Salta, A4400ANG Salta, Argentina.
authors.forename: Dennis W T
authors.initials: DW
authors.lastname: Nilsen