The effects of vitamin D supplementation on postoperative atrial fibrillation after coronary artery bypass grafting in patients with vitamin D deficiency

Abstract

Introduction: Postoperative atrial fibrillation (POAF) as a common complication of coronary artery bypass grafting (CABG) surgery is associated with increased mortality and morbidity rates. Vitamin D deficiency increases the prevalence of POAF; however, the effects of vitamin D supplementation on the incidence of POAF have not yet been completely elucidated. Methods: In this prospective, open-label, randomized clinical trial the level of 25-hydroxy vitamin D (25(OH) D) was measured in patients undergoing CABG surgery. Patients with vitamin D insufficiency (defined as 25(OH) D level < 30 ng/ml)were included and randomly assigned to control group to receive either the general standard of care (Group A) or to study group to receive the general standard of care plus oral vitamin D 3 , 600,000 IU 5 days before surgery (Group B). The primary outcome of our study was the occurrence of POAF during the first 5 days after CABG surgery.Results: Totally, 93 patients in group B and 103 patients in group A completed the study. The occurrence of POAF was significantly lower in group B as compared to group A (9.68% vs. 20.39%, p = .038). The length of intensive care unit (ICU) stay and hospital stay were reduced in group B patients (2.21 vs. 3.86 days, p < .001 and 7.40 vs. 9.58 days, p = .022, respectively). Conclusion:Our study demonstrated that vitamin D supplementation reduces the incidence of POAF, duration of ICU, and hospital stay following CABG surgery.

Effect of Vitamin D Supplementation on Postoperative Outcomes in Cardiac Surgery Patients: A Systematic Review

“…7 8 Three studies (37.5%) detected significant reduction in postoperative atrial fibrillation (POAF) by vitamin D therapy. 9 10 Two studies (25%) detected significant reduction in inotrope requirement postoperatively compared with control group. 11 One study (12.5%) observed marked reduction in duration of ICU and hospital stay in vitamin D supplementation group compared with control.…”

“…POAF: The present systemic review detected three RCTs showing reduction in POAF by vitamin D supplementation. 9 10 19 However, Sahu et al 8 did not find any difference. Conflicting results were seen by a prospective cohort study by Ohlrogge et al for POAF with VDD.…”

Vitamin D supplementation and postoperative atrial fibrillation

“…In the study, which included 196 patients, the patients were divided into two groups as those with and without vitamin D supplementation. At the end of the study, the rate of PoAF was found to be significantly higher in patients who did not receive vitamin D supplementation (9.68% vs. 20.39%, p = .038) 10 . In this study, postoperative electrocardiography follow‐ups were performed with continuous telemetry.…”

“…In a recent metaanalysis and systematic review study, it was concluded that vitamin D deficiency increases the risk of PoAF. 9 In this issue of the Journal of Cardiac Surgery, in a study conducted by Talasaz et al, 10 the effect of preoperative oral vitamin D supplementation on PoAF in patients with vitamin D deficiency who underwent CABG was investigated. In the study, which included 196 patients, the patients were divided into two groups as those with and without vitamin D supplementation.…”

“…At the end of the study, the rate of PoAF was found to be significantly higher in patients who did not receive vitamin D supplementation (9.68% vs. 20.39%, p = .038). 10 In this study, postoperative electrocardiography followups were performed with continuous telemetry. This situation increases the value of the study.…”