Why the study?
Vitamin D deficiency is prevalent and emerging as a risk factor for coronary artery disease, but its relationship with coronary thrombus burden, TIMI flow grade, and myocardial blush grade in patients undergoing primary PCI for first STEMI needed evaluation.
Do abnormal serum vitamin D levels affect coronary thrombus grade, TIMI flow, and myocardial blush grade in patients with acute STEMI undergoing primary PCI?
Do abnormal serum vitamin D levels affect coronary thrombus grade, TIMI flow, and myocardial blush grade in patients with acute STEMI undergoing primary PCI?
Normal vitamin D levels are associated with better myocardial blush grade and microvascular reperfusion in STEMI patients undergoing primary PCI, though not with epicardial TIMI flow or thrombus burden.
Normal vitamin D levels were associated with better microvascular reperfusion in STEMI; hypothesis-generating and requires prospective validation before practice change.
BACKGROUND: Vitamin D deficiency is a prevalent condition that is found in about 30-50% of the general population, and it is increasing as a new risk factor for coronary artery disease. Our study aimed to evaluate the relationship of serum vitamin D levels with coronary thrombus burden, Thrombolysis In Myocardial Infarction flow grade, and myocardial blush grade in patients managed by primary percutaneous coronary intervention for their first acute ST-segment elevation myocardial infarction. RESULTS: Eighty patients were included in the study with their first acute ST-segment elevation myocardial infarction and were managed by primary percutaneous coronary intervention. According to the serum concentrations of vitamin D, the study population was divided into 2 groups: group A with abnormal vitamin D levels less than 30 ng/ml (50 patients) and group B with normal vitamin D levels equal to or more than 30 ng/ml (30 patients). Angiographic data was recorded before and after coronary intervention. On comparing thrombus grade and initial and post-procedural Thrombolysis In Myocardial Infarction flow between both groups of patients, there was no significant difference (p = 0.327, p = 0.692, p = 0.397). However, myocardial blush grade was better in patients with normal vitamin D levels (p = 0.029) without a significant correlation between vitamin D concentration values and myocardial blush grade (r = 0.164, p = 0.146). CONCLUSIONS: Patients with first acute ST-segment elevation myocardial infarction and normal vitamin D levels undergoing primary percutaneous coronary intervention had better myocardial blush grade and more successful microvascular reperfusion in comparison with patients with abnormal vitamin D levels. There was no significant difference between the normal and abnormal vitamin D groups regarding the coronary thrombus grade and Thrombolysis In Myocardial Infarction flow.
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Abdallah et al. (2020) studied this question.
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