Vitamin D Uptake in Patients Treated with a High-Dosed Purified Omega-3 Compound in a Randomized Clinical Trial Following an Acute Myocardial Infarction

BackgroundFish is the natural dietary source of vitamin D. Reports on the influence of purified omega-3 fatty acids on its uptake are scarce.ObjectivesWe investigated the impact of a purified high-dose omega-3 compound compared to corn oil on 25-hydroxyvitamin D [25(OH)D] levels following an acute myocardial infarction.Methods228 patients were randomized 1:1 to receive a daily dose of either 4 g omega-3 (OMACOR®) or an equal dose of corn oil, administered double-blindly for 12 months. Total omega-3 and omega-6 measurements were available in 40 randomly picked patients.ResultsThere was no significant intergroup difference in 25(OH)D changes at 12 months follow-up (p = 0.12), but there was a minor statistical significant intragroup increase in 25(OH)D in both intervention arms (p < 0.001 for n-3 polyunsaturated fatty acids and p = 0.013 for corn oil, respectively). A positive correlation was noted between 25(OH)D and omega-3 prior to inclusion; r = 0.418, p = 0.007, attenuated at 12 months by purified omega-3 intervention; r = 0.021, p = 0.93. No positive correlation was observed between omega-6 and 25(OH)D.ConclusionLong-term treatment with a high dose of purified omega-3 as compared to corn oil did not improve serum concentrations of vitamin D.Clinical Trial Registration:ClinicalTrials.gov, Identifier: NCT01422317

B-type natriuretic peptide and high sensitive C-reactive protein predict 2-year all cause mortality in chest pain patients: a prospective observational study from Salta, Argentina

Abstract Background Several mechanisms are involved in the pathophysiology of the Acute Coronary Syndrome (ACS). We have addressed whether B-type natriuretic peptide (BNP) and high-sensitive C-reactive protein (hsCRP) in admission samples may improve risk stratification in chest pain patients with suspected ACS. Methods We included 982 patients consecutively admitted with chest pain and suspected ACS at nine hospitals in Salta, Northern Argentina. Total and cardiac mortality were recorded during a 2-year follow up period. Patients were divided into quartiles according to BNP and hsCRP levels, respectively, and inter quartile differences in mortality were statistically evaluated applying univariate and multivariate analyses. Results 119 patients died, and the BNP and hsCRP levels were significantly higher among these patients than in survivors. In a multivariable Cox regression model for total death and cardiac death in all patients, the hazard ratio (HR) in the highest quartile (Q4) as compared to the lowest quartile (Q1) of BNP was 2.32 (95% confidence interval (CI), 1.24-4.35), p = 0.009 and 3.34 (95% CI, 1.26-8.85), p = 0.015, respectively. In the TnT positive patients (TnT > 0.01 ng/mL), the HR for total death and cardiac death in Q4 as compared to Q1 was 2.12 (95% CI, 1.07-4.18), p = 0.031 and 3.42 (95% CI, 1.13-10.32), p = 0.029, respectively. The HR for total death for hsCRP in Q4 as compared to Q1 was 1.97 (95% CI, 1.17-3.32), p = 0.011, but this biomarker did not predict cardiac death (p = 0.21). No prognostic impact of these two biomarkers was found in the TnT negative patients. Conclusion BNP and hsCRP may act as clinically useful biomarkers when obtained at admission in a population with suspected ACS. Trial Registration ClinicalTrials.gov Identifier: NCT01377402.</p

Suggested Cut-Off Values for Vitamin D as a Risk Marker for Total and Cardiac Death in Patients with Suspected Acute Coronary Syndrome

Background: Several studies have demonstrated an association between low vitamin D levels and cardiovascular risk. Vitamin D cut-off levels are still under debate.Objectives: To assess two cut-off levels, 40 and 70 nmol/L, respectively, for vitamin D measured as 25-hydroxyvitamin D in chest pain patients with suspected acute coronary syndrome.Methods: We investigated 1853 patients from coastal-Norway and inland NorthernArgentina. A similar database was used for pooling of data. Two-year follow-up data including all-cause mortality, cardiac death, and sudden cardiac death in the total patient population were analyzed, applying univariate and multivariable analysis.Results: Two hundred fifty-five patients with known vitamin D concentrations died. In the multivariable analysis, there was a decrease in total mortality above a cut-off level of 40 nmol/L and a decrease in cardiac death above a cut-off level of 70 nmol/L [HRs of 0.66 (95% CI, 0.50?0.88), p = 0.004 and 0.46 (95% CI, 0.22?0.94), p = 0.034, respectively].Conclusion: Vitamin D cut-off levels of 40 and 70 nmol/L were related to total mortality and cardiac death, respectively.Fil: Naesgaard, Patrycja A.. Stavanger University Hospital; Noruega. University Of Bergen; NoruegaFil: Leon de la Fuente, Ricardo Alfonso. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Stavanger University Hospital; Noruega. University Of Bergen; Noruega. Universidad Católica de Salta; ArgentinaFil: Nilsen, Stein Tore. Stavanger University Hospital; Noruega. University Of Bergen; NoruegaFil: Pönitz, Volker. Stavanger University Hospital; NoruegaFil: Brügger Andersen, Trygve. Stavanger University Hospital; NoruegaFil: Grundt, Heidi. University Of Bergen; Noruega. Stavanger University Hospital; NoruegaFil: Staines, Harry. Sigma Statistical Services; Reino UnidoFil: Nilsen, Dennis W. T.. Stavanger University Hospital; Noruega. University Of Bergen; Norueg

Kaplan-Meier plots for total mortality of 25(OH)D quartiles in the total patient population.

<p>Kaplan-Meier plots for total mortality of 25(OH)D quartiles in the total patient population.</p

Kaplan-Meier plots for total mortality of 25(OH)D quartiles in patients with TnT release.

<p>Kaplan-Meier plots for total mortality of 25(OH)D quartiles in patients with TnT release.</p

Receiver operated characteristics curve for 25(OH)D related to all-cause mortality in the total patient population.

<p>Receiver operated characteristics curve for 25(OH)D related to all-cause mortality in the total patient population.</p

Hazard ratios for 25(OH)D, age, TnT, BNP, hsCRP and BMI.

<p>Values are given as hazard ratio (95% CI).</p><p>25(OH)D, 25-hydroxyvitamin D; TnT, troponin T; BNP, B-type natriuretic peptide; hsCRP, high sensitivity C-reactive protein; BMI, body mass index.</p