Daily Supplementation with 4000 IU Vitamin D3 for Three Years Does Not Modify Cardiovascular Risk Markers in Patients with Advanced Heart Failure: The Effect of Vitamin D on Mortality in Heart Failure Trial

Abstract

Background/Aims: We aimed to investigate the effect of a moderately high vitamin D dose on lipid parameters and biochemical markers of vascular calcification (VC) in patients with established cardiovascular disease. Methods: We included in this pre-specified secondary analysis of a randomized controlled trial 161 patients with advanced heart failure and 25-hydroxyvitamin D (25OHD) concentrations < 75 nmol/L (vitamin D group: n = 80; placebo group: n = 81), who received a daily vitamin D₃ supplement of 4,000 IU for 3 years. We assessed between-group differences of the lipid parameters total-cholesterol, high-density lipoprotein-cholesterol, low-density lipoprotein-cholesterol, and triglycerides, and the VC markers fetuin-A and non-phosphorylated undercarboxylated matrix gla protein (MGP) at study termination, with adjustment for baseline values. Results: Lipid parameters, the percentage of patients with dyslipoproteinemia, and VC markers did not differ significantly between groups at study termination (p values: 0.395–0.939). Likewise, vitamin D achieved no significant treatment effect on these markers in subgroup analyses in patients with 25OHD concentrations < 30 nmol/L, nonusers of lipid-lowering drugs, or diabetic patients (p values: 0.245–0.998). Conclusion: Our data indicate that vitamin D does not improve the lipid profile and does not influence the calcification inhibitors fetuin-A and non-phosphorylated undercarboxylated MGP in patients with advanced heart failure.

Heart Disease and Stroke Statistics—2023 Update: A Report From the American Heart Association

“…In addition, no sex-specific vitamin D effects were found. 115 A similar study, a post hoc analysis of the EVITA trial, assessing daily vitamin D 3 supplementation of 4000 IU, also found no improvement in cardiac function among patients with advanced HF. However, subgroup analyses among those ≥50 years of age indicated improvements of 2.73% in LVEF (95% CI, 0.14%–5.31%) at the 12-month follow-up and 2.60% (95% CI, −2.47% to 7.67%) improvement at the 36-month follow-up.…”

The effect of vitamin D deficiency and vitamin D supplementation on the risk of cardiovascular diseases

“…Lipid parameters and vascular calcification markers did not differ significantly between groups. Therefore, vitamin D had no positive effect on the lipid profile and no effect on the calcification inhibitors (fetuin-A) in heart failure patients [41].…”

Uso da vitamina D para a diminuição do risco cardiovascular em pacientes com diabetes mellitus tipo II: Uma Revisão Sistemática

“…A princípio foi observado um aumento nos níveis de HDL no grupo que sofreu a intervenção, dado esse não observado no tocante ao não-HDL e LDL de forma isolada, ficando os dois grupos em pé de igualdade. Também não foram encontradas mudanças nos níveis de triglicerídeos nos pacientes dos dois grupos, assim não havendo mudança nos parâmetros lipídicos que pudessem afetar o risco cardiovascular no perfil dos pacientes presentes no estudo (Zittermann et al, 2018).…”

“…Nesse contexto, a vitamina D tem sido apontada como uma alternativa terapêutica promissora. Trata-se de um importante pró-hormônio esteroide lipofílico, conhecido por seu papel fundamental na homeostase do cálcio e do fósforo e saúde musculoesquelético, mas que possui múltiplas funções fisiológicas, atuando na diferenciação e proliferação celular, secreção hormonal, no sistema imune e em diversas doenças crônicas não transmissíveis (Wacker & Hollick, 2013;Mcdonnell et al, 2016;Muscogiuri et al, 2016;Zittermann et al, 2018).…”