Assessment of the synergistic association of serum concentration of vitamin D, vitamin K and osteocalcin with coronary atherosclerosis in patients undergoing angiography

Objective: The aim of this study was to assess the association between serum concentration of vitamin D, vitamin K, and osteocalcin with coronary atherosclerosis in patients undergoing angiography. Design: In this case-control study, 138 people who referred to Bushehr Heart Center for routine examination participated. Demographic information of the participants was registered by using a standard questionnaire. Before undergoing the angiographic processes, venous blood samples were obtained via venipuncture from the antecubital vein into gel and clot activator tubes and stored at – 80 °C until the analysis. After the angiography process was over, the normal participants entered the control group and those with coronary atherosclerosis plaque placed in the case group. Finally, serum levels of vitamin K2 and Osteocalcin were measured in the samples, by using ELISA kits and the serum level of vitamin D was measured by using HPLC. Result: serum levels of vitamin D in the case group were significantly lower than in the control (p = 0.009) and, serum levels of osteocalcin in the case group were significantly higher than in the control (P = 0.019). There was no difference in K2 level between the two groups (P = 0.84). By separating the three factors like age, sex and T2DM in the two groups, a significant synergistic was found between the concentration of osteocalcin, vitamin D (just in <20 ng/ml) and coronary atherosclerosis (p = 0.025, p = 0.029 respectively). Further, an association was observed between vitamin D level and the severity of atherosclerosis (P = 0.041).). Conclusion: the results of this study suggest that the increase in the level of osteocalcin and the deficiency of vitamin D is significantly associated with coronary atherosclerosis but, not with vitamin k2. Moreover, serum vitamin D concentration is associated with severity of coronary atherosclerosis

Relationship of Serum Levels of Vitamin K2 and Osteocalcin with Atherosclerotic Coronary Arteries

Background: This study aimed to evaluate the relationship of serum levels of vitamin K2 and osteocalcin with coronary artery plaques in people undergoing angiography. Materials and Methods: This case-control study enrolled 138 people presenting to Bushehr Heart Center for routine examination. Demographic information of the participants was registered in a standard questionnaire. Before undergoing angiography, 10 ml blood was collected from all the participants and stored at – 80 ˚C until the analysis. After the angiography, those who were found to be normal entered the control group, and those with one or more arteries blocked were placed in the case group. Finally, serum levels of vitamin K2 and osteocalcin were measured in all the samples using ELISA kits. Results: Serum levels of osteocalcin in the case group were significantly higher than those of the control (P=0.019). There was no difference in K2 levels between the two groups (P=0.84). Moreover, no relationship was found between the osteocalcin levels and the number of blocked arteries and the severity of atherosclerosis (P=0.95). By adjusting age and type 2 diabetes in both groups, a difference was observed in the concentration of osteaocalcin and coronary artery atherosclerosis (P=0.034). Conclusion: Our results showed that a significant relationship exists between increased concentration of serum osteocalcin and coronary artery atherosclerosis. However, no such a relationship was observed between the serum levels of K2 and atherosclerotic arteries

Angiotensin-converting enzyme 2: A double-edged sword in COVID-19 patients with an increased risk of heart failure

The coronavirus disease(COVID-19) pandemic is a global health priority. Given that cardiovascular diseases (CVD) are the leading cause of morbidity around the world and that several trials have reported severe cardiovascular damage in patients infected with SARS-CoV-2, a substantial number of COVID-19 patients with underlying cardiovascular diseases need to continue their medications in order to improve myocardial contractility and to prevent the onset of major adverse cardiovascular events (MACEs), including heart failure. Some of the current life-saving medications may actually simultaneously expose patients to a higher risk of severe COVID-19. Angiotensin-converting enzyme 2 (ACE2), a key counter regulator of the renin-angiotensin system (RAS), is the main entry gate of SARS-CoV2 into human host cells and an established drug target to prevent heart failure. In fact, ACE inhibitors, angiotensin II receptor blockers, and mineralocorticoid antagonists may augment ACE2 levels to protect organs from angiotensin II overload. Elevated ACE2 expression on the host cell surface might facilitate viral entrance, at the same time sudden non-adherence to these medications triggers MACEs. Hence, safety issues in the use of RAS inhibitors in COVID-19 patients with cardiac dysfunction remains an unsolved dilemma and needs paramount attention. Although ACE2 generally plays an adaptive role in both healthy subjects and patients with systolic and/or diastolic dysfunction, we conducted a literature appraisal on its maladaptive role. Understanding the exact role of ACE2 in COVID-19 patients at risk of heart failure is needed to safely manage RAS inhibitors in frail and non-frail critically ill patients