The relationship between inflammatory markers and vitamin D levels with the severity of coronary artery disease in elderly patients

Introduction: Coronary artery disease (CAD) is the accumulation of atherosclerotic plaques in the coronary arteries. CAD is the most common cause of death worldwide, and its prevalence continues to increase, especially in the elderly population. Atherosclerosis is a chronic inflammatory condition that involves various inflammatory markers, including tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6). In the inflammatory process, vitamin D plays an essential role in developing atherosclerotic plaques affecting the severity of CAD. The elderly are susceptible to vitamin D deficiency and an increase in the inflammatory process related to the severity of CAD. Therefore, this study aims to prove the relationship between inflammatory markers and vitamin D levels with the severity of CAD in elderly patients. Methods: This study used a cross-sectional design in stable CAD patients aged 60 - 75 years who had passed through coronary arteriography. The severity was assessed from the angiography results using the Synergy between PCI with Taxus and Cardiac Surgery (SYNTAX) score, which 3 cardiovascular consultants evaluated and the average outcome was calculated. TNF-α, IL-6, and vitamin D were taken during angiography and examined using high sensitivity enzyme-linked immunoabsorbent assay (ELISA). The correlation test was analyzed using Spearman's Rank correlation test. Results: A total of 38 subjects were included in this study, where 30 (78.9%) patients were male. The mean age of the patients was 64.79 years, and the prevalence of vitamin D deficiency was 57.9%. There was a moderately significant positive correlation between markers of inflammation TNF-α (r=0.499, p=0.001) and IL-6 (r=0.518, p=0.001) and the SYNTAX score. A weak negative correlation was also discovered between vitamin D and the SYNTAX score (r=-0.335, p=0.040). Conclusion: The levels of inflammatory markers (TNF-α and IL-6) and vitamin D correlated with the severity of CAD in elderly patients.