Vitamin B12 and Vitamin D3 Deficiency- Association with Premature Coronary Artery Disease

Background: Premature coronary artery disease (PCAD), defined as the occurrence of CAD in individuals younger than 45 years, is on the rise globally, particularly in South Asian countries. While traditional risk factors such as smoking, hypertension, and diabetes are well established, recent studies suggest that micronutrient deficiencies, particularly Vitamin B12 and Vitamin D3, may play a critical role in the early development and severity of CAD. Aim: To evaluate the association between Vitamin B12 and Vitamin D3 deficiencies and the severity of premature coronary artery disease in patients aged below 45 years. Methods: This prospective observational study was conducted at the Department of Medicine and Cardiology, ANMMCH, involving 110 patients with angiographically confirmed PCAD. Clinical profiles, vitamin levels, and coronary angiographic findings were recorded. Vitamin B12 and D3 levels were measured using chemiluminescence assays. Statistical analysis was performed using SPSS version 23.0, and associations were assessed using chi-square and correlation analyses. Results: Of the 110 individuals, 57.3% had deficiencies in vitamin B12, 64.5% had deficiencies in vitamin D3, and 37.3% had deficiencies in both. Deficiency rates were much greater in those with double- and triple-vessel disease. Vitamin levels and the severity of CAD were found to be statistically significantly inversely correlated (p < 0.05), with higher Gensini scores being linked to lower vitamin levels. Conclusion: The study discovered a strong correlation between elevated PCAD severity and vitamin B12 and D3 deficits. These inadequacies might be modifiable risk factors that could help younger people develop coronary artery disease earlier and more rapidly. Recommendations: Routine screening for Vitamin B12 and D3 levels should be considered in young patients presenting with or at risk of CAD. Further longitudinal and interventional studies are needed to explore the impact of vitamin supplementation on cardiovascular outcomes. Keywords: Vitamin B12, Vitamin D3, Premature Coronary Artery Disease, Micronutrient Deficiency, Atherosclerosis