Vitamin D Deficiency Is Associated with Severity of Acute Coronary Syndrome in Patients with Type 2 Diabetes and High Rates of Sun Exposure

BACKGROUND Vitamin D deficiency has been associated with cardiovascular risk factors, including type 2 diabetes mellitus (T2DM). Evidence shows that patients with low serum 25-hydroxyvitamin D (25OHD) concentrations have a higher risk of developing coronary artery disease. OBJECTIVE The objective of this study was to assess vitamin D as a predictor of the severity in diabetics with acute coronary syndrome (ACS). METHODS A total of 166 patients were diagnosed with ACS. Serum 25OHD concentrations were analyzed, and risk factors for ACS were evaluated. RESULTS Patients diagnosed as having acute myocardial infarction with elevation of the ST segment had a higher rate of 25OHD, <20 ng/mL compared to ≥30 ng/mL (47.8% × 13.4%, P = 0.03). Diabetics with vitamin D deficiency had more multivessel lesions in the coronary angiography than non-diabetics (69% × 31.8%, P = 0.007). After adjustments for confounders, serum 25OHD remained associated with more severe disease. CONCLUSION Vitamin D deficiency is associated with more severe ACS and is a predictor of more extensive coronary lesions in patients with T2DM.