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Death in less than 2 years of Heart Failure associated with low vitamin D - April 2012

Vitamin D Deficiency is a Predictor of Reduced Survival in Patients With Heart Failure

Israel Gotsman; Ayelet Shauer; Donna R. Zwas; Yaron Hellman; Andre Keren; Chaim Lotan; Dan Admon
Eur J Heart Fail. 2012;14(4):357-366. © 2012 Oxford University Press

Aims Vitamin D deficiency is a highly prevalent, global phenomenon. The prevalence in heart failure (HF) patients and its effect on outcome are less clear. We evaluated vitamin D levels and vitamin D supplementation in patients with HF and its effect on mortality.

Methods and results 25-Hydroxyvitamin D [25(OH)D] levels were evaluated in HF patients from a health maintenance organization (HMO), and compared them with those of the rest of the members of the HMO.

Patients with HF (n = 3009) had a lower median 25(OH)D level compared with the control group (n = 46 825): 36.9 nmol/L (interquartile range 23.2–55.9) vs. 40.7 nmol/L (26.7–56.9), respectively, P < 0.00001.

The percentage of patients with vitamin D deficiency [25(OH)D <25 nmol/L] was higher in patients with HF compared with the control group (28% vs. 22%, P < 0.00001).

Only 8.8% of the HF patients had optimal 25(OH)D levels (?75 nmol/L).
Median clinical follow-up was 518 days. Cox regression analysis demonstrated that vitamin D deficiency was an independent predictor of increased mortality in patients with HF [hazard ratio (HR) 1.52, 95% confidence interval (CI) 1.21–1.92, P < 0.001] and in the control group (HR 1.91, 95% CI 1.48–2.46, P < 0.00001).

Vitamin D supplementation was independently associated with reduced mortality in HF patients (HR 0.68, 95% CI 0.54–0.85, P < 0.0001).

Parameters associated with vitamin D deficiency in HF patients were decreased previous solar radiation exposure, body mass index, diabetes, female gender, pulse, and decreased calcium and haemoglobin levels.

Conclusions Vitamin D deficiency is highly prevalent in HF patients and is a significant predictor of reduced survival. Vitamin D supplementation was associated with improved outcome.

After HF more people died if low vitamin D

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People died if low vitamin D - even those who did not have heart failure

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PDF is attached at the bottom of this page

Attached files

ID Name Comment Uploaded Size Downloads
1527 Death without HF and low D.jpg admin 08 Aug, 2012 24.45 Kb 1461
1526 Death after HF and low D.jpg admin 08 Aug, 2012 22.89 Kb 1466
1525 HF then death and low vitamin D.pdf admin 08 Aug, 2012 1.76 Mb 1312