Background: Growing bulk of data inferred from medical literature favors the significant association between serum calcium and vascular disorders. Some of this literature has been collected and analyzed globally in meta-analysis studies. It has been shown that the rate of death is higher with higher serum calcium concentrations. However, some studies have shown that higher calcium levels are associated with other cardiovascular risk factors such as dyslipidemia, hypertension, and obesity, questioning the direct contribution of raised serum calcium as a risk factor for cardiovascular disorders. Aim of the study: To compare mean serum calcium between patients with ischemic heart disease and individuals known to be free of ischemic heart disease. Patients and methods: The current study was conducted at Al-Diwaniyah Teaching Hospital in Al-Diwaniyah Province, Iraq. The study started on January the 2nd 2018 and ended on June the 15th 2018 and it was designed to be a case-control study. The study group included a total of 40 patients with a diagnosis of ischemic heart disease, 20 patients with unstable angina (UA), and 20 patients with acute myocardial infarction (MI). Those patients were recruited for the pool of patients admitted to the coronary care unit at the hospital. The control group included 40 individuals who were not known to have ischemic heart disease with comparable age. Results: there was significant in mean serum calcium among patients and control subjects (P = 0.021); the serum level of the control group was significantly lower than that of patients with unstable angina and patients with myocardial infarction (P < 0.05), but, the level was not significantly different between patients with unstable angina and patients with myocardial infarction (P > 0.05). Conclusion: the significantly higher serum calcium in patients with ischemic heart disease in comparison with individuals lacking ischemic heart disease may be an indicator of a possible role of serum calcium in the pathogenesis of ischemic heart disease.
Cite this article:
Hassan Raji Jalab. Serum calcium in association with ischemic heart disease: a case-control study in the coronary care unit at Al-Diwaniyah Teaching Hospital. Research J. Pharm. and Tech 2020; 13(6): 2932 -2935. doi: 10.5958/0974-360X.2020.00540.5
Hassan Raji Jalab. Serum calcium in association with ischemic heart disease: a case-control study in the coronary care unit at Al-Diwaniyah Teaching Hospital. Research J. Pharm. and Tech 2020; 13(6): 2932 -2935. doi: 10.5958/0974-360X.2020.00540.5 Available on: https://rjptonline.org/AbstractView.aspx?PID=2020-13-6-72
1. Reid IR, Bristow SM, Bolland MJ. Calcium and Cardiovascular Disease. Endocrinol Metab (Seoul). 2017;32(3):339–349.
2. Murphy E, Bassett JH, Williams GR. Disorders of calcium metabolism. Practitioner 2006;250:4–6.
3. Ko B. Parathyroid hormone and the regulation of renal tubular calcium transport. Curr Opin Nephrol Hypertens. 2017;26:405‐410.
4. Jones BL, Smith SM. Calcium-Sensing Receptor: A Key Target for Extracellular Calcium Signaling in Neurons. Front Physiol. 2016;7:116. Published 2016 Mar 30. doi:10.3389/fphys.2016.00116
5. Lu B, Zhang Q, Wang H, Wang Y, Nakayama M, Ren D. Extracellular calcium controls background current and neuronal excitability via an UNC79-UNC80-NALCN cation channel complex. Neuron. 2010;68(3):488–499. doi:10.1016/j.neuron.2010.09.014
6. Blaine J, Chonchol M, Levi M. Renal control of calcium, phosphate, and magnesium homeostasis [published correction appears in Clin J Am Soc Nephrol. 2015 Oct 7;10(10):1886-7]. Clin J Am Soc Nephrol. 2015;10(7):1257–1272.
7. Kuo IY, Ehrlich BE. Signaling in muscle contraction. Cold Spring Harb Perspect Biol. 2015;7(2):a006023. Published 2015 Feb 2. doi:10.1101/cshperspect.a006023
8. Baker S.B., Worthley L.I. The essentials of calcium, magnesium and phosphate metabolism: part I. Physiology. Crit. Care Resusc. 2002;4:301–306.
9. Callan MB, Shofer FS, Catalfamo JL. Effects of anticoagulant on pH, ionized calcium concentration, and agonist-induced platelet aggregation in canine platelet-rich plasma. Am J Vet Res. 2009;70(4):472–477. doi:10.2460/ajvr.70.4.472
10. Gupta AK, Kumar P, Keshav K, Singh A. Hydroxyapatite crystals as a bone graft substitute in benign lytic lesions of bone. Indian J Orthop. 2015;49(6):649–655. doi:10.4103/0019-5413.168767
11. Bonjour JP. Calcium and phosphate: a duet of ions playing for bone health. J Am Coll Nutr 2011;30(5 suppl 1):438S–48S.
12. Fearnley CJ, Roderick HL, Bootman MD. Calcium signaling in cardiac myocytes. Cold Spring Harb Perspect Biol. 2011;3(11):a004242. Published 2011 Nov 1. doi:10.1101/cshperspect.a004242
13. Hill-Eubanks DC, Werner ME, Heppner TJ, Nelson MT. Calcium signaling in smooth muscle. Cold Spring Harb Perspect Biol. 2011;3(9):a004549. Published 2011 Sep 1. doi:10.1101/cshperspect.a004549
14. Varga-Szabo D., Braun A., Nieswandt B. Calcium signaling in platelets. J. Thromb. Haemost. 2009;7:1057–1066.
15. Pérez-Hernández N, Aptilon-Duque G, Blachman-Braun R, et al. Vascular Calcification: Current Genetics Underlying This Complex Phenomenon. Chin Med J (Engl). 2017;130(9):1113–1121. doi:10.4103/0366-6999.204931
16. Chen NC, Hsu CY, Chen CL. The Strategy to Prevent and Regress the Vascular Calcification in Dialysis Patients. Biomed Res Int. 2017;2017:9035193. doi:10.1155/2017/9035193
17. Wu M, Rementer C, Giachelli CM. Vascular calcification: an update on mechanisms and challenges in treatment. Calcif Tissue Int. 2013;93(4):365–373. doi:10.1007/s00223-013-9712-z
18. Vinanti GB, Pavan D, Rossato A, Biz C. Atypical localizations of calcific deposits in the shoulder. Int J Surg Case Rep. 2015;10:206–210. doi:10.1016/j.ijscr.2015.04.011
19. Miller NL, Humphreys MR, Coe FL, et al. Nephrocalcinosis: re-defined in the era of endourology. Urol Res. 2010;38(6):421–427. doi:10.1007/s00240-010-0328-8
20. Cai MM, Smith ER, Holt SG. The role of fetuin-A in mineral trafficking and deposition. Bonekey Rep. 2015;4:672. Published 2015 May 6. doi:10.1038/bonekey.2015.39
21. Reid IR, Gamble GD, Bolland MJ. Circulating calcium concentrations, vascular disease and mortality: a systematic review. J Intern Med. 2016;279:524–540.
22. Jorde R, Sundsfjord J, Fitzgerald P, Bonaa KH. Serum calcium and cardiovascular risk factors and diseases: the Tromso study. Hypertension. 1999;34:484–490.
23. Foley RN, Collins AJ, Ishani A, Kalra PA. Calcium-phosphate levels and cardiovascular disease in community-dwelling adults: the Atherosclerosis Risk in Communities (ARIC) Study. Am Heart J. 2008;156:556–563.
24. Jin Y, He L, Wang Q, et al. Serum calcium levels are not associated with coronary heart disease. Vasc Health Risk Manag. 2013;9:517–520. doi:10.2147/VHRM.S49136
25. Shin S, Kim KJ, Chang HJ, Cho I, Kim YJ, Choi BW, et al. Impact of serum calcium and phosphate on coronary atherosclerosis detected by cardiac computed tomography. Eur Heart J. 2012;33:2873–2881.
26. Kwak SM, Kim JS, Choi Y, Chang Y, Kwon MJ, Jung JG, et al. Dietary intake of calcium and phosphorus and serum concentration in relation to the risk of coronary artery calcification in asymptomatic adults. Arterioscler Thromb Vasc Biol. 2014;34:1763–1769.
27. Bolland MJ, Wang TK, van Pelt NC, Horne AM, Mason BH, Ames RW, et al. Abdominal aortic calcification on vertebral morphometry images predicts incident myocardial infarction. J Bone Miner Res. 2010;25:505–512.
28. Ishizaka N, Ishizaka Y, Takahashi E, Tooda E, Hashimoto H, Nagai R, et al. Serum calcium concentration and carotid artery plaque: a population-based study. J Cardiol. 2002;39:151–157.
29. Rubin MR, Rundek T, McMahon DJ, Lee HS, Sacco RL, Silverberg SJ. Carotid artery plaque thickness is associated with increased serum calcium levels: the Northern Manhattan study. Atherosclerosis. 2007;194:426–432.