Evidence map›Paper›PMID 40911594›Full record

Observational studyPloS one2025

Relationship of vitamin D, fibrinogen and their ratio with acute coronary syndrome: A comparative analysis of unstable angina, NSTEMI, and STEMI.

Himayat Ullah, Sarwat Huma, Muhammad Ashraf, Nafisa Tahir, Ghulam Yasin, Mohammed Yunus, Hossam Shabana, Mohamed Ahmed Muharram, Abdulrahman H Shalaby, Ahmed Ali Hassan Ali and 23 more

Abstract readMulticenter StudyObservational StudyComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

33 authors.

Himayat UllahCollege of Medicine at Shaqra, Shaqra University, Saudi Arabia.
Sarwat HumaHealth Services Academy, Hayatabad Medical Complex, Peshawar, Islamabad, Pakistan.ORCID https://orcid.org/0009-0006-3134-2443
Muhammad AshrafCollege of Medicine at Shaqra, Shaqra University, Saudi Arabia.
Nafisa TahirNUST School of Health Science, National University of Science and Technology, Islamabad, Pakistan.
Ghulam YasinCollege of Medicine at Shaqra, Shaqra University, Saudi Arabia.
Mohammed YunusKabul University of Medical Sciences (KUMS), Kabul, Afghanistan.ORCID https://orcid.org/0009-0001-1258-044X
Hossam ShabanaCollege of Medicine at Shaqra, Shaqra University, Saudi Arabia.
Mohamed Ahmed MuharramFaculty of Medicine, Al-Azhar University, Cairo, Egypt.
Abdulrahman H ShalabyFaculty of Medicine, Al-Azhar University, Cairo, Egypt.
Ahmed Ali Hassan AliFaculty of Medicine, Al-Azhar University, Cairo, Egypt.ORCID https://orcid.org/0009-0004-8072-1648
Mohamed Elwan Mohamed MahmoudFaculty of Medicine, Al-Azhar University, New Damietta, Egypt.
Ahmed Mahrous Ahmed IbrahimFaculty of Medicine, Al-Azhar University, Cairo, Egypt.
Ahmed Farag Abd Elkader ElbwabFaculty of Medicine, Al-Azhar University, Cairo, Egypt.
Ahmed Mohamed Ewis AlhawyFaculty of Medicine, Al-Azhar University, Cairo, Egypt.ORCID https://orcid.org/0009-0003-7784-9918
Ahmed Ahmed Mohamed AbotahaFaculty of Medicine, Al-Azhar University, Cairo, Egypt.
Mahmoud Ezzat AbdelraoufFaculty of Medicine, Al-Azhar University, Cairo, Egypt.
Mohammed S ImamFaculty of Medicine, Al-Azhar University, Cairo, Egypt.
Hossam Aladl Aladl AladlFaculty of Medicine, Al-Azhar University, Cairo, Egypt.
Taiseer Ahmed ShawkyFaculty of Medicine, Al-Azhar University, Cairo, Egypt.
Ashraf Mohammed SaidFaculty of Medicine, Al-Azhar University, Cairo, Egypt.
Mahmoud Saeed MahmoudFaculty of Medicine, Al-Azhar University, New Damietta, Egypt.
Kazem Mohamed TayeeFaculty of Medicine, Al-Azhar University, Cairo, Egypt.
Reda Fakhry MohamedFaculty of Medicine, Al-Azhar University, Cairo, Egypt.
Ali Hosni FarahatFaculty of Medicine, Al-Azhar University, Cairo, Egypt.
Mohammad Mossaad Abd Allah AlsayyadFaculty of Medicine, Al-Azhar University, New Damietta, Egypt.
Hesham El Sayed LashinFaculty of Medicine, Al-Azhar University, Cairo, Egypt.
Essam Yehia Ali AggourFaculty of Medicine, Al-Azhar University, Cairo, Egypt.
Hazem Sayed Ahmed AyoubFaculty of Medicine, Al-Azhar University, Cairo, Egypt.
Ayman Mohamed Salem AhmedFaculty of Medicine, Al-Azhar University, Cairo, Egypt.
Marwan Sayed Mohamed AhmedFaculty of Medicine, Al-Azhar University, Cairo, Egypt.
Abdelrahman E MetwallyCardiovascular Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Ahmed Saeed AbdelazizCardiovascular Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Tamer Ahmed Fouad Mohammed HassanCardiovascular Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThere is emerging evidence suggesting that vitamin D and fibrinogen play contrasting roles in ACS pathophysiology and their combined impact, expressed as the vitamin D/fibrinogen ratio, can be a potential biomarker for ACS severity. This study aimed to investigate the relationship between vitamin D, fibrinogen, and their ratio with ACS types, and assess their potential as risk stratification biomarkers.

methodsThis multicenter observational study was conducted in tertiary care hospitals in Afghanistan, Egypt, and Pakistan, including 300 ACS patients. Serum vitamin D and fibrinogen levels were measured using electrochemiluminescence immunoassay and the Clauss method, respectively. Statistical analyses included ANOVA, Kruskal-Wallis, post-hoc Games-Howell tests, Spearman's correlation, Fisher's Z-test, and multivariable logistic regression.

resultsVitamin D levels were significantly lower (p < 0.001) and fibrinogen levels significantly higher (p < 0.001) in STEMI patients compared to NSTEMI and UA. The vitamin D/fibrinogen ratio showed a stronger correlation with ACS severity (Spearman's rho = -0.45, p = 0.01) than vitamin D alone (-0.41, p = 0.01), but this difference was not statistically significant (Fisher Z = 0.34, p = 0.73). Logistic regression revealed that a 1 nmol/L increase in vitamin D reduced ACS severity by 7.1% (p = 0.043), while a unit increase in the vitamin D/fibrinogen ratio reduced severity by 6.2% (p = 0.048).

conclusionThe contrasting effects of vitamin D and fibrinogen can prove useful biomarkers and modifiable risk factors for ACS. The superiority of the vitamin D/fibrinogen ratio over vitamin D only, however, needs further validation in larger studies.

Indexed as

Acute Coronary SyndromeAngina, UnstableFibrinogenNon-ST Elevated Myocardial InfarctionST Elevation Myocardial InfarctionVitamin DAgedBiomarkersFemaleHumansMaleMiddle AgedBiomarkersFibrinogenVitamin D

Identifiers

PMID40911594
PMCPMC12412923

What Socratic holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.