LAUSR

Type of funding sources: None. Previously we have demonstrated that hypovitaminosis D is common in the Italian population and it has a comparable deleterious effect to diabetes mellitus on survival after an acute myocardial infarction (AMI). Here, we sough to evaluate if the prevalence of hypovitaminosis D changed over time, considering also frequent lockdowns in the last years due to COVID-19 pandemic. Our large population of 1042 patients hospitalized for AMI, were divided into three groups, according to the year of enrollment: group 1 included 368 patients enrolled between 2014-2016, group 2 with 470 patients enrolled between 2017- 2019, and group 3 from 204 patients enrolled in the last three years, 2020-2022). We determined Vitamin D level at hospital admission and we evaluated whether the concentration of vitamin D changed in the last decade. The median concentration of vitamin D in our cohort of patients with AMI was 18.2 (11.48-25.73) ng/ml). Throughout the three groups (2014-2016, 2017-2019, 2020-2022), the median plasma vitamin D showed a trend toward an increase (17.3 (10.33 – 24.2) ng/ml, 18.95 (11.6 – 26.73) ng/ml, and 19.05 (12.5 – 27.3) ng/ml respectively), which was significant between the group 1 vs 2 and 3 (p = 0.033 and p = 0.004, respectively), while between the group 2 and 3 did not. Despite the trend of increase, the percentage of patients with hypovitaminosis D in each group remained high (61.4%, 53.8% and 52.0% respectively). As expected, samples taken between May and September have significantly higher vitamin D values compared to ones taken from October to April for each group (the group 1: 21.80 (15.55 – 31.23) ng/ml vs 15.8 (9.22 – 23.98) ng/ml, p < 0.0001; the group 2: 22.05 (14.10 – 30.98) ng/ml vs 16.50 (11.03 – 23.90) ng/ml, p < 0.0001); the group 3: 20.00 (11.90 – 26.90) ng/ml vs 16.30 (9.75 – 22.30) ng/ml, p = 0.001). In all three groups, low levels of Vitamin D were associated with worse outcome as previously we have shown. There has been a trend of increasing vitamin D values over the years, but insufficient vitamin D levels persists. We did not observed a decrease of Vitamin D levels, over the pandemic, possibly due to media awareness that emphasized the significance of vitamin D administration against viral infection.