Circulating vitamin D levels are associated with the presence and severity of coronary artery disease but not peripheral arterial disease in patients undergoing coronary angiography

Background and aims: To investigate the association between vitamin D levels, angiographic severity of coronary artery disease, arterial stiffness and degree of peripheral arterial disease (PAD) as assessed by ankle brachial index (ABI). Methods and results: 375 patients undergoing coronary angiography from November 2012 to September 2013 were recruited. Serum 25-hydroxyvitamin D (25OHD) levels were measured as were ABI and pulse wave velocity (PWV). Based on the findings of the coronary angiogram, patients were divided into subgroups: Absent, Single, Double and Triple Vessel Disease (as defined by >50% stenosis in each major coronary artery) 0.275 patients not taking vitamin D supplements were included in the analysis. Mean age was 66.0 +/- 11.2 (mean +/- SD) years. Levels of 25(OH) D were significantly lower in patients with CAD when compared to patients without CAD (57.0 +/- 1.73 versus 70.1 +/- 2.46 nmol/L; p < 0.01). One way ANOVA revealed triple vessel disease patients had significantly lower 25(OH) D levels when compared to single vessel disease patients (50.6 +/- 2.84 nmol/L versus 61.3 +/- 3.16 p < 0.01) and trended to be lower when compared to double vessel disease patients (50.6 +/- 2.84 versus 59.0 +/- 2.99 nmol/L; p = 0.07). Stepwise regression revealed that age, gender (male), hypertension, hyperlipidemia and 25(OH) D were significant predictors of CAD (p < 0.05). Vitamin D was the most significant predictor for CAD (p < 0.001) There was no correlation between 25(OH) D levels, ABI and PWV. Conclusion: Among patients presenting for coronary angiography, low serum 25-hydroxyvitamin D levels are associated with the presence and extent of angiographic CAD but not arterial stiffness or PAD. (C) 2014 Elsevier B.V. All rights reserved.