This study aimed to evaluate serum vitamin D level’s relationship with coronary thrombus grade, Thrombolysis In Myocardial Infarction (TIMI) flow, and myocardial blush grade (MBG) in patients with first acute STEMI undergoing primary PCI. The prevalence of vitamin D deficiency was estimated to be approximately 30–50% of the general population, and several studies have shown an association between vitamin D deficiency and cardiovascular diseases (CVD) including hypertension (HTN), acute myocardial infarction (AMI), heart failure, CAD, metabolic syndrome, and diabetes mellitus (DM). Vitamin D deficiency causes endothelial dysfunction through its direct or indirect effect through the upregulation of the renin-angiotensin system or via induction of smooth muscle proliferation and a pro-inflammatory state. The pathogenesis of no-reflow is known to be multi-factorial, and its possible mechanisms include injury related to ischemia, reperfusion, endothelial dysfunction, microvascular spasm, and distal thromboembolism. In STEMI, the incidence of no-reflow has been reported to be ranging between 11 and 41%, depending on several clinical and angiographic factors in addition to the adopted definition of no-reflow. Primary percutaneous coronary intervention (PCI) is the favorable treatment option for restoring perfusion to the affected area of the myocardium as soon as possible. There was no significant difference between the normal and abnormal vitamin D groups regarding the coronary thrombus grade and Thrombolysis In Myocardial Infarction flow.ĭespite the medical and technological improvements in the re-vascularization procedures in coronary artery diseases (CAD), ST-segment elevation myocardial infarction (STEMI) remains a significant health concern. Patients with first acute ST-segment elevation myocardial infarction and normal vitamin D levels undergoing primary percutaneous coronary intervention had better myocardial blush grade and more successful microvascular reperfusion in comparison with patients with abnormal vitamin D levels. However, myocardial blush grade was better in patients with normal vitamin D levels ( p = 0.029) without a significant correlation between vitamin D concentration values and myocardial blush grade ( r = 0.164, p = 0.146). On comparing thrombus grade and initial and post-procedural Thrombolysis In Myocardial Infarction flow between both groups of patients, there was no significant difference ( p = 0.327, p = 0.692, p = 0.397). Angiographic data was recorded before and after coronary intervention. According to the serum concentrations of vitamin D, the study population was divided into 2 groups: group A with abnormal vitamin D levels less than 30 ng/ml (50 patients) and group B with normal vitamin D levels equal to or more than 30 ng/ml (30 patients). ResultsĮighty patients were included in the study with their first acute ST-segment elevation myocardial infarction and were managed by primary percutaneous coronary intervention. Our study aimed to evaluate the relationship of serum vitamin D levels with coronary thrombus burden, Thrombolysis In Myocardial Infarction flow grade, and myocardial blush grade in patients managed by primary percutaneous coronary intervention for their first acute ST-segment elevation myocardial infarction. Vitamin D deficiency is a prevalent condition that is found in about 30–50% of the general population, and it is increasing as a new risk factor for coronary artery disease.
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