Abstract
BACKGROUND: Few studies have examined the relationship between vitamin D and the risk of recurrent cardiovascular events in people with coronary heart disease (CHD). AIM: This study aimed to investigate the associations of serum 25-hydroxyvitamin D [25(OH)D] concentration and the vitamin D receptor (VDR) polymorphisms with the risk of recurrent cardiovascular events in individuals with established CHD. METHODS: A total of 22,571 participants with CHD were included from the UK Biobank. Recurrent cardiovascular events, including myocardial infarction (MI), heart failure (HF), stroke, and CVD mortality, were identified from electronic health records. Cox proportional hazard models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS: The median (interquartile range) of serum 25(OH)D concentration was 44.8 (30.3, 61.4) nmol/L, and 58.6% of participants had 25(OH)D below 50 nmol/L. During a median follow-up of 11.2 years, a total of 3,998 recurrent cardiovascular events were documented. After multivariable adjustment, there was a non-linear inverse relationship between serum 25(OH)D and recurrent cardiovascular events (P non-linearity <0.01), and the decreasing risk gradually leveled off at around 50 nmol/L. Compared with participants with serum 25(OH)D <25.0 nmol/L, the HRs (95% CIs) for participants with serum 25(OH)D of 50.0-74.9 nmol/L were 0.64 (0.58, 0.71) for recurrent cardiovascular events, 0.78 (0.65, 0.94) for MI, 0.66 (0.57, 0.76) for HF, and 0.66 (0.52, 0.84) for stroke. In addition, these associations were not modified by genetic variants in the VDR. INTERPRETATION: In people with established CHD, higher serum 25(OH)D concentrations were non-linearly associated with a lower risk of recurrent cardiovascular events, with a potential threshold around 50 nmol/L. These findings highlight the importance of maintaining adequate vitamin D status in the prevention of recurrent cardiovascular events among individuals with CHD.
14 Authors
- Xiaoyu Lin
- Xue Chen
- Sen Liu
- Yulei Deng
- Yuexuan Wang
- Qi Lu
- Rui Li
- Yunjing Ou
- Qingying Tian
- Yunfei Liao
- Guanglin Cui
- Kun Yang
- An Pan
- Gang Liu
1 Application
Application ID | Title |
68307 | Environmental and genetic determinants of morbidity and mortality among adults with cardiometabolic disorders |