Impact of serum vitamin (Vitamin D, Vitamin B12) and trace element (Fe, Zn, Cu) levels on major adverse cardiovascular events and poor prognosis in STEMI patients undergoing primary PCI

To investigate the impact of serum vitamin (25-hydroxyvitamin D3 [25(OH)D3] and vitamin B12) and trace element (iron [Fe], zinc [Zn], and copper [Cu]) levels on major adverse cardiovascular events (MACE) and prognosis in patients with first-onset ST-segment elevation myocardial infarction (STEMI) after percutaneous coronary intervention (PCI). A total of 202 first-onset STEMI patients undergoing emergency PCI were prospectively enrolled and divided into MACE (n = 72) and non-MACE (n = 130) groups according to 12-month postoperative MACE occurrence. Baseline characteristics, cardiac function parameters, and serum levels of 25(OH)D3, vitamin B12, Fe, Zn, and Cu were measured. Multivariate logistic regression was performed to identify independent influencing factors. Receiver operating characteristic curves were used to evaluate predictive value for MACE. Kaplan-Meier analysis was conducted to assess associations with rehospitalization rates and quality of life (SF-36 scale). The MACE group exhibited significantly lower serum 25(OH)D3, vitamin B12, and Zn levels but higher Fe and Cu levels compared with the non-MACE group. Multivariate analysis identified 25(OH)D3, vitamin B12, and Zn were independently associated with a lower risk of MACE, while Fe and Cu were independently associated with a higher risk of MACE. The combined predictive AUC of 25(OH)D3 and vitamin B12 for MACE was 0.79, which was superior to individual indicators. Moreover, abnormal levels were associated with higher 12-month rehospitalization rates and lower SF-36 scores. Decreased serum 25(OH)D3, vitamin B12, and Zn levels and elevated Fe/Cu levels are significantly associated with MACE occurrence and poor prognosis in first-onset STEMI patients post-PCI.