PMID- 31188902
OWN - NLM
STAT- MEDLINE
DCOM- 20200317
LR  - 20200317
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 14
IP  - 6
DP  - 2019
TI  - The association between vitamin D status and clinical events in high-risk older 
      patients with non-ST elevation acute coronary syndrome undergoing invasive 
      management.
PG  - e0217476
LID - 10.1371/journal.pone.0217476 [doi]
LID - e0217476
AB  - There is a higher incidence of vitamin D deficiency in older adults. This may 
      play a plausible mechanistic role in the occurrence of increased adverse events 
      after non-ST elevation acute coronary syndrome (NSTEACS). This study investigated 
      whether total vitamin D levels at the time of presentation predicted adverse 
      outcomes in older adults undergoing invasive management of NSTEACS. Of the 629 
      patients screened, 300 high-risk older adults with NSTEACS managed by an invasive 
      strategy were recruited. Serum total 25-hydroxyvitamin D was measured at index 
      presentation. The primary outcome was defined as 1-year composite of all-cause 
      mortality, acute coronary syndrome (ACS), unplanned repeat revascularisation, 
      significant bleeding or stroke. Mean age was 80.5+/-4.8 years (61.9% male). Median 
      vitamin D level was 29.5nmol/L [interquartile range IQR 16.0-53.0 nmol/L] and was 
      split equally by the median for analysis forming two groups: high (median vitamin 
      D 53.0 nmol/L [IQR 40.0-75.0]) and low (16.0 nmol/L [11.0-23.0]). The primary 
      outcome occurred in 76 patients (25.9%); 32 (21.9%) in the low group and 44 
      (29.9%) in the high group, p = 0.12. Multivariable analyses showed no significant 
      difference in the primary composite outcome at 1 year between the low and high 
      group of baseline serum vitamin D (Hazard Ratio 1.20 [95% Confidence Interval 
      0.72-2.0], p = 0.48). Serum total vitamin D, measured at the time of angiography, 
      was not associated with adverse outcomes at one year in this high-risk older 
      cohort of patients with NSTEACS undergoing invasive management.
FAU - Beska, Benjamin
AU  - Beska B
AD  - Institute of Cellular Medicine, Faculty of Medical Sciences, Newcastle 
      University, Newcastle upon Tyne, United Kingdom.
AD  - Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne Hospitals NHS 
      Foundation Trust, Newcastle upon Tyne, United Kingdom.
FAU - Chan, Danny
AU  - Chan D
AD  - Institute of Cellular Medicine, Faculty of Medical Sciences, Newcastle 
      University, Newcastle upon Tyne, United Kingdom.
AD  - Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne Hospitals NHS 
      Foundation Trust, Newcastle upon Tyne, United Kingdom.
FAU - Gu, Sophie
AU  - Gu S
AD  - Institute of Cellular Medicine, Faculty of Medical Sciences, Newcastle 
      University, Newcastle upon Tyne, United Kingdom.
AD  - Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne Hospitals NHS 
      Foundation Trust, Newcastle upon Tyne, United Kingdom.
FAU - Qiu, Weiliang
AU  - Qiu W
AD  - Channing Division of Network Medicine, Department of Medicine, Brigham and 
      Women's Hospital/Harvard Medical School, Boston, MA, United States of America.
FAU - Mossop, Helen
AU  - Mossop H
AD  - Institute of Health and Society, Newcastle University, Newcastle upon Tyne, 
      United Kingdom.
FAU - Neely, Dermot
AU  - Neely D
AD  - Department of Biochemistry, Newcastle upon Tyne Hospitals NHS Foundation Trust, 
      Newcastle upon Tyne, United Kingdom.
FAU - Kunadian, Vijay
AU  - Kunadian V
AUID- ORCID: 0000-0003-2975-6971
AD  - Institute of Cellular Medicine, Faculty of Medical Sciences, Newcastle 
      University, Newcastle upon Tyne, United Kingdom.
AD  - Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne Hospitals NHS 
      Foundation Trust, Newcastle upon Tyne, United Kingdom.
LA  - eng
GR  - DH_/Department of Health/United Kingdom
GR  - CS/15/7/31679/BHF_/British Heart Foundation/United Kingdom
PT  - Clinical Trial
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20190612
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
RN  - 1406-16-2 (Vitamin D)
SB  - IM
MH  - Acute Coronary Syndrome/*blood/*etiology
MH  - Aged
MH  - Aged, 80 and over
MH  - Cohort Studies
MH  - Coronary Angiography/methods
MH  - Female
MH  - Hemorrhage/blood/etiology
MH  - Humans
MH  - Male
MH  - Percutaneous Coronary Intervention/methods
MH  - Risk Factors
MH  - Stroke/blood/etiology
MH  - Vitamin D/*blood
MH  - Vitamin D Deficiency/blood/complications
PMC - PMC6561555
COIS- The authors have declared that no competing interests exist.
EDAT- 2019/06/13 06:00
MHDA- 2020/03/18 06:00
PMCR- 2019/06/12
CRDT- 2019/06/13 06:00
PHST- 2018/12/13 00:00 [received]
PHST- 2019/05/12 00:00 [accepted]
PHST- 2019/06/13 06:00 [entrez]
PHST- 2019/06/13 06:00 [pubmed]
PHST- 2020/03/18 06:00 [medline]
PHST- 2019/06/12 00:00 [pmc-release]
AID - PONE-D-18-35529 [pii]
AID - 10.1371/journal.pone.0217476 [doi]
PST - epublish
SO  - PLoS One. 2019 Jun 12;14(6):e0217476. doi: 10.1371/journal.pone.0217476. 
      eCollection 2019.