We finally get a good Vitamin D study!
Low vitamin D linked to sudden cardiac death
Monday, Nov. 17, 2008; 12:26 PM
NEW YORK (Reuters Health) - Vitamin D deficiency is associated with heart dysfunction, sudden cardiac death, and death due to heart failure, German researchers report.
An association between vitamin D deficiency and heart trouble is physiologically plausible, the researchers note. For example, vitamin D is known to affect contractility of the heart.
Dr. Stefan Pilz, from the University of Heidelberg, and colleagues assessed vitamin D levels in 3,299 Caucasian patients who were referred for a test used to look for clogged heart arteries called coronary angiography from 1997 to 2000. The subjects were then followed for 7.7 years.
During follow-up, 116 patients died from heart failure and 188 from sudden cardiac death, Pilz and colleagues report.
In analyses taking into factors that might influence the results, they found that severe vitamin D deficiency, compared with optimal vitamin D levels, was associated with nearly a three-fold increased risk of death from heart failure and about a five-fold increased risk of sudden cardiac death.
"These data strongly indicate that the maintenance of an optimal vitamin D status may be a promising approach for the prevention and/or therapy of (heart) diseases, warranting confirmation in interventional trials with vitamin D supplementation," the researchers conclude.
SOURCE: Journal of Clinical Endocrinology and Metabolism October, 2008.
Association of Vitamin D Deficiency with Heart Failure and Sudden Cardiac Death in a Large Cross-Sectional Study of Patients Referred for Coronary Angiography
Stefan Pilz, Winfried März, Britta Wellnitz, Ursula Seelhorst, Astrid Fahrleitner-Pammer, Hans P. Dimai, Bernhard O. Boehm and Harald Dobnig
Department of Public Health, Social and Preventive Medicine (S.P., W.M.), Mannheim Medical Faculty, University of Heidelberg, 68135 Mannheim, Germany; Department of Internal Medicine (S.P., A.F.-P., H.P.D., H.D.), Division of Endocrinology and Nuclear Medicine, Medical University of Graz, 8010 Graz, Austria; Synlab Center of Laboratory Diagnostics (W.M.), 69037 Heidelberg, Germany; LURIC Study Nonprofit LLC (B.W., U.S.), Freiburg, Germany; and Department of Internal Medicine I (B.O.B.), Division of Endocrinology and Diabetes, Ulm University, 89070 Ulm, Germany
Address all correspondence and requests for reprints to: Stefan Pilz, Department of Internal Medicine, Division of Endocrinology and Nuclear Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria. E-mail: stefan.pilz@chello.at.; or Harald Dobnig, Department of Internal Medicine, Division of Endocrinology and Nuclear Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria. E-mail: harald.dobnig@meduni-graz.at.
Context: Vitamin D has been shown to influence cardiac contractility and myocardial calcium homeostasis.
Objectives: We aimed to elucidate whether insufficient vitamin D status is associated with heart failure and sudden cardiac death (SCD).
Design, Setting, and Participants: We measured 25-hydroxyvitamin D [25(OH)D] levels in 3299 Caucasian patients who were routinely referred to coronary angiography at baseline (1997–2000).
Main Outcome Measures: The main outcome was cross-sectional associations of 25(OH)D levels with measures of heart failure and Cox proportional hazard ratios for deaths due to heart failure and for SCD according to vitamin D status.
Results: 25(OH)D was negatively correlated with N-terminal pro-B-type natriuretic peptide and was inversely associated with higher New York Heart Association classes and impaired left ventricular function. During a median follow-up time of 7.7 yr, 116 patients died due to heart failure and 188 due to SCD. After adjustment for cardiovascular risk factors, the hazard ratios (with 95% confidence intervals) for death due to heart failure and for SCD were 2.84 (1.20–6.74) and 5.05 (2.13–11.97), respectively, when comparing patients with severe vitamin D deficiency [25(OH)D <25 nmol/liter)] with persons in the optimal range [25(OH)D =75 nmol/liter]. In all statistical analyses, we obtained similar results with 25(OH)D and with 1,25-dihydroxyvitamin D.
Conclusions: Low levels of 25(OH)D and 1,25-dihydroxyvitamin D are associated with prevalent myocardial dysfunction, deaths due to heart failure, and SCD. Interventional trials are warranted to elucidate whether vitamin D supplementation is useful for treatment and/or prevention of myocardial diseases. |
