Acute Coronary Syndrome Clinical Trial
Official title:
Intervention Study Measuring Inflammatory Cytokine Levels in the Serum of Patients Who Underwent an Acute MI, and the Influence of Vitamin D on These Levels
Vitamin D is known to have immune-modulator effects including suppression of proinflammatory
cytokine expression and regulation of immune cell activity. Vitamin D supplementation has
been associated with a reduction in pro-inflammatory cytokines in patients with heart
failure, and vitamin D deficiency has been associated with higher rates of myocardial
infarcts. The levels of pro and anti-inflammatory cytokines also effect the outcome after
acute coronary events.
The proposed interventional study is targeted as a feasibility study targeted at assessing
the role of vitamin D as an anti-inflammatory mediator.
The study is planned as a randomized open label interventional trial. The study will be
conducted of 50 adult patients (25 interventional group, 25 control), all from the internal
ward in "Meir" medical center. Patients which are admitted after an acute coronary event will
be randomized to the Vitamin D supplementation group or to the control group. the vitamin D
group will receive 4000IU per day of vitamin D for five days. Cytokine levels will be
measured at day 1 and at day 5. follow up will be continued for 6 months
Primary end point:
Levels of immune mediating cytokines (CRP, TNF-α. Il-2, IL-6, IL-12 and IL-10) after a five
day intervention in patients serum.
Secondary endpoints:
Any major cardiovascular event within follow-up period. Any death of any cause during
follow-up period
Expected results:
the investigators expect vitamin D supplementation after a pro-inflammatory state such as an
acute coronary event, combined with conventional therapy, to result in decreased levels of
inflammatory serum bio-markers.
Inclusion criteria:
- Acute coronary syndrome (as defined previously).
- No advanced renal disease (creatinine levels < 1.8 for men and 1.5 for women).
- No known parathyroid or calcium homeostasis abnormalities
- Baseline Calcium levels within normal limits.
- No vitamin D supplementation taken within 4 months of current admission.
- No coexisting pro-inflammatory conditions (e.g. infection, active autoimmune disease)
- No coexisting immune-mediator agents (e.g. corticosteroids, anti-TNF or other biological
agents).
- No participation in other interventional studies.
- Signing an informed consent form.
Exclusion criteria:
- Advanced renal failure
- Abnormal serum calcium levels upon admission
- Primary parathyroid or calcium homeostasis abnormalities.
- Coexisting pro-inflammatory conditions (e.g. infection, active autoimmune disease)
- Coexisting immune-mediator agents (e.g. corticosteroids, anti-TNF or other biological
agents)
- Participation in other interventional studies.
- Inability or refusal to sign an informed consent.
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