Relationship of vitamin D, fibrinogen and their ratio with acute coronary syndrome: A comparative analysis of unstable angina, NSTEMI, and STEMI.
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Ullah Himayat, Huma Sarwat, Ashraf Muhammad, Tahir Nafisa, Yasin Ghulam, Yunus Mohammed, Shabana Hossam, Muharram Mohamed Ahmed, Shalaby Abdulrahman H, Ali Ahmed Ali Hassan, Mahmoud Mohamed Elwan Mohamed, Ibrahim Ahmed Mahrous Ahmed, Elbwab Ahmed Farag Abd Elkader, Ewis Alhawy Ahmed Mohamed, Abotaha Ahmed Ahmed Mohamed, Abdelraouf Mahmoud Ezzat, Imam Mohammed S, Aladl Hossam Aladl Aladl, Shawky Taiseer Ahmed, Said Ashraf Mohammed, Mahmoud Mahmoud Saeed, Tayee Kazem Mohamed, Mohamed Reda Fakhry, Farahat Ali Hosni, Alsayyad Mohammad Mossaad Abd Allah, Lashin Hesham El Sayed, Aggour Essam Yehia Ali, Ayoub Hazem Sayed Ahmed, Ahmed Ayman Mohamed Salem, Ahmed Marwan Sayed Mohamed, Metwally Abdelrahman E, Abdelaziz Ahmed Saeed, Hassan Tamer Ahmed Fouad Mohammed
Аннотация
METHODS: This multicenter observational study was conducted in tertiary care hospitals in Afghanistan, Egypt, and Pakistan, including 300 ACS patients. Serum vitamin D and fibrinogen levels were measured using electrochemiluminescence immunoassay and the Clauss method, respectively. Statistical analyses included ANOVA, Kruskal-Wallis, post-hoc Games-Howell tests, Spearman's correlation, Fisher's Z-test, and multivariable logistic regression.
RESULTS: Vitamin D levels were significantly lower (p < 0.001) and fibrinogen levels significantly higher (p < 0.001) in STEMI patients compared to NSTEMI and UA. The vitamin D/fibrinogen ratio showed a stronger correlation with ACS severity (Spearman's rho = -0.45, p = 0.01) than vitamin D alone (-0.41, p = 0.01), but this difference was not statistically significant (Fisher Z = 0.34, p = 0.73). Logistic regression revealed that a 1 nmol/L increase in vitamin D reduced ACS severity by 7.1% (p = 0.043), while a unit increase in the vitamin D/fibrinogen ratio reduced severity by 6.2% (p = 0.048).
CONCLUSION: The contrasting effects of vitamin D and fibrinogen can prove useful biomarkers and modifiable risk factors for ACS. The superiority of the vitamin D/fibrinogen ratio over vitamin D only, however, needs further validation in larger studies.