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Modification of the association between smoking status and severity of coronary stenosis by vitamin D in patients suspected of coronary heart disease
- Source :
- Medicine
- Publication Year :
- 2016
-
Abstract
- Given both smoking and vitamin D are associated with coronary heart disease (CHD) via inflammation and smoking may interfere with the local antiinflammatory effects of vitamin D. We hypothesized that the relationship between smoking and severity of CHD may be modified by vitamin D. A cross-sectional study was conducted. 25-OH vitamin D values were determined in 348 consecutive patients (mean age 62.4 ± 10.5 years; 56.3% male) undergoing coronary angiography at the Heart Center of Chaoyang Hospital affiliated to Capital Medical University between the period of September 2014 and May 2015. We categorized the patients into 2 groups based on 25-OH vitamin D levels, that is, severe hypovitaminosis D (25-OH vitamin D = 10 ng/mL). Multivariable logistic regression models were used to estimate odds ratios (ORs) of severe coronary stenosis or higher Gensini score across three smoking status, that is, never smokers, former smokers, and current smokers in severe hypovitaminosis D and higher vitamin D groups, respectively. Of these patients, we identified 212 (60.9%) cases of severe CHD and 161 (46.3%) cases of severe hypovitaminosis D. Multivariable logistic regression model showed the ORs of severe CHD were 1.94 (95% confidence interval [CI]: 0.47, 7.98) for former smokers and 2.62 (95% CI: 0.83, 8.24) for current smokers, compared with never smokers in group with severe hypovitaminosis D (P-trend = 0.005). In contrast, smoking was not found to be significantly associated with severe CHD in group with higher 25-OH vitamin D (P-trend = 0.115). We found a significant interaction between smoking status and vitamin D on presence of severe CHD (P-interaction = 0.015). In terms of Gensini score as a dependent variable, similar results were identified. Our finding indicated the association between smoking and severity of CHD appeared to be substantially stronger among patients with severe hypovitaminosis D as compared with those with higher vitamin D levels. This suggests vitamin D sufficiency may have a protective effect against the damaging effects of smoking on coronary artery. Future cohort studies are warranted to confirm this finding.
- Subjects :
- Vitamin
Adult
Male
medicine.medical_specialty
Cross-sectional study
Observational Study
interaction
Inflammation
vitamin D
030204 cardiovascular system & hematology
Coronary Angiography
Severity of Illness Index
03 medical and health sciences
chemistry.chemical_compound
0302 clinical medicine
Internal medicine
Severity of illness
Vitamin D and neurology
medicine
Humans
In patient
cardiovascular diseases
030212 general & internal medicine
coronary heart disease
Aged
Aged, 80 and over
business.industry
Smoking
Coronary Stenosis
General Medicine
Middle Aged
Vitamin D Deficiency
Coronary heart disease
Surgery
Cross-Sectional Studies
chemistry
Cardiology
Smoking status
Female
medicine.symptom
business
Research Article
Subjects
Details
- ISSN :
- 15365964
- Volume :
- 95
- Issue :
- 36
- Database :
- OpenAIRE
- Journal :
- Medicine
- Accession number :
- edsair.doi.dedup.....b51d21cffa7aa612a90e728fb25d73ad