Association of Vitamin D Deficiency as an Independent Risk Factor for Myocardial Infarction and Its Therapeutic Implications: A Systematic Review

维生素D缺乏作为心肌梗死独立危险因素及其治疗意义:系统评价

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Abstract

Vitamin D deficiency is a highly prevalent condition globally and has emerged as a significant risk factor for the development of coronary artery disease (CAD). Although its role in the regulation of phospho-calcic metabolism is well established, its involvement in the evolution of myocardial infarction (MI) is yet to be fully understood. Vitamin D deficiency is a manageable condition, and a reasonable time to assess and commence treatment is crucial, as the patient presents with acute myocardial infarction (AMI). This article discusses the various mechanisms through which vitamin D may prevent MI, including its role in the development of atherosclerosis, as well as its cardioprotective effects. Cardiomyocytes and vascular smooth muscle have exhibited the presence of the vitamin D receptor (VDR) on the surface. Vitamin D deficiency also plays a crucial role in upregulating inflammatory cytokines and activating the renin-angiotensin-aldosterone system (RAAS). This review aims to explore the implications of vitamin D deficiency on MI by assessing multiple observational studies and randomized controlled trials. The findings suggest a positive correlation between low serum vitamin D levels and the incidence of MI, based on observational studies. Additionally, studies reflect that hypovitaminosis D predisposes AMI patients to post-infarction complications and cardiac remodeling. Contrastingly, the impact of vitamin D supplementation on mitigating the risk of MI is debatable, as evidenced by interventional studies. Future research is thus warranted to showcase the promising approach of vitamin D supplementation in lowering the risk of MI, alongside investigating optimal dosing and evaluating long-term impacts on cardiovascular morbidity and mortality.

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