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Open Access Research article

Association of 25-hydroxyvitamin D deficiency with NT-pro BNP levels in patients with acute myocardial infarction: a cross-sectional analysis

James B Wetmore123*, Rajyalakshmi Gadi1, John H Lee4, James H O'Keefe4, Paul S Chan4, Fengming Tang4 and John A Spertus4

Author Affiliations

1 Division of Nephrology and Hypertension, University of Kansas Medical Center, Kansas City, KS, USA

2 University of Kansas Medical Center, Kidney Institute, Kansas City, KS, USA

3 University of Kansas Medical Center, MS 3002, 3901 Rainbow Blvd, Kansas City, KS 66160, USA

4 Department of Cardiovascular Outcomes Research, Saint Luke's Mid America Heart Institute, Kansas City, MO, USA

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BMC Research Notes 2011, 4:542  doi:10.1186/1756-0500-4-542

Published: 15 December 2011

Abstract

Background

Nutritional vitamin D deficiency is an emerging risk factor for acute myocardial infarction (AMI) and heart failure. The association of 25-hydroxyvitamin D levels with N-terminal pro B-type natriuretic peptide (NT-proBNP), a robust prognostic marker for post-AMI mortality and heart failure, is unknown and could illuminate a potential pathway for adverse outcomes among post-AMI patients with 25-hydroxyvitamin D deficiency.

Methods

In a cross-sectional analysis, we studied 238 AMI patients from 21 U.S. centers to test the association of nutritional vitamin D (25-hydroxyvitamin D [25(OH)D]) deficiency with NT-proBNP levels. Levels of 25(OH)D levels were categorized as normal (≥30 ng/mL), insufficient (>20 - <30 ng/mL), deficient (>10 - ≤20 ng/mL), or severely deficient (≤10 ng/mL).

Results

Low 25(OH)D levels were found in 95.7% of AMI patients. No significant trends for higher mean baseline log NT-proBNP levels in severely deficient (6.9 ± 1.3 pg/mL), deficient (6.9 ± 1.2 pg/mL), and insufficient (6.9 ± 0.9 pg/ml) groups were observed as compared with patients having normal (6.1 ± 1.7 pg/mL) levels, P = 0.17. Findings were similar in the subset of patients who had follow-up NT-proBNP levels drawn at one month. In multivariate regression modeling, after adjusting for multiple covariates, 25(OH)D was not associated with NT-proBNP.

Conclusions

Potential associations between nutritional vitamin D deficiency and prognosis in the setting of AMI are unlikely to be mediated through NT-proBNP pathways. Future studies should examine other mechanisms, such as inflammation and vascular calcification, by which 25(OH)D deficiency could mediate adverse outcomes post-AMI.

Keywords:
Vitamin D; N-terminal proBNP; Acute myocardial infarction