The relationship between serum vitamin d and bare-metal in-stent restenosis in patients with stable coronary artery disease

Abstract

Aim: It has been shown that low levels of vitamin D are associated with increased cardiovascular risk factors and adverse events. The relationship between serum vitamin D level and bare-metal stent in-stent restenosis was investigated in our study.Material and Methods: A total of 181 patients with stable coronary artery disease and previously implanted (>3 months) bare-metal stent were included in the study. Two groups were formed according to angiographic results as Group 1 (≥50% in-stent stenosis) and Group 2 (<50% in-stent stenosis). Serum vitamin D measurements were performed by reverse-phase HPLC. Results: The mean serum vitamin D levels were found to be significantly lower in Group 1 compared to Group 2 (17.7 ± 5.3 ng/ml and 20.9 ± 6.7 ng/ml, p<0.01, respectively) and length of stent was longer in Group 1 compared to Group 2 (18.7 ± 5.3 mm and 17.1 ± 11.2 mm, p<0.01, respectively). In multivariate logistic regression analysis, only low level of serum vitamin D and stent length were independent risk factors for bare-metal in-stent stenosis.Conclusion: Low level of vitamin D might be related to fibrosis and inflammation resulting in in-stent stenosis. Further studies are warranted to determine whether vitamin D supplementation could prevent progression of stent re-stenosis.