Dow University of Health Sciences, Karachi, Pakistan.
Dow University of Health Sciences, Karachi, Pakistan.
J Cardiol. 2023 Sep;82(3):220-224. doi: 10.1016/j.jjcc.2023.05.007. Epub 2023 May 24.
Vitamin D insufficiency/deficiency has been identified as a risk factor for postoperative atrial fibrillation (POAF) after coronary artery bypass grafting (CABG). This is associated with significantly increased morbidity and mortality leading to not only prolonged hospital and intensive care unit (ICU) stay, but increased risk of stroke, heart failure, dementia, and long-term atrial fibrillation. This analysis aims to evaluate the efficacy of vitamin D supplementation in preventing POAF in patients undergoing CABG.
We searched PubMed, Cochrane Central Register of Controlled Trials and SCOPUS from inception to June 2022 for randomized controlled trials (RCTs). The outcome of interest was the incidence of POAF. Secondarily, we analyzed the length of ICU stay, length of hospital stay, cardiac arrest, cardiac tamponade, and blood transfusion. Results were pooled using a random-effect model. Three RCTs consisting of 448 patients were included.
Our results suggest that vitamin D significantly reduced the incidence of POAF (RR: 0.60; 95 % CI: 0.40, 0.90; p = 0.01; I = 8 %). It was also observed that vitamin D significantly reduced the duration of ICU stay (WMD: -1.639; 95 % CI: -1.857, -1.420; p < 0.00001). Furthermore, the length of hospital stay (WMD: -0.85; 95 % CI: -2.14, 0.43; p = 0.19; I = 87 %) was also reduced, however, the result was not significant.
Our pooled analysis suggests that vitamin D prevents POAF. Future large-scale randomized trials are needed to confirm our results.
维生素 D 不足/缺乏已被确定为冠状动脉旁路移植术后（CABG）发生房性心律失常（POAF）的危险因素。这与发病率和死亡率显著增加有关，不仅导致住院时间和重症监护病房（ICU）停留时间延长，而且增加中风、心力衰竭、痴呆和长期心房颤动的风险。本分析旨在评估维生素 D 补充在预防 CABG 患者 POAF 中的疗效。
我们从 1975 年 1 月至 2022 年 6 月在 PubMed、Cochrane 对照试验中心注册库和 Scopus 上搜索了随机对照试验（RCT）。感兴趣的结局是 POAF 的发生率。其次，我们分析了 ICU 入住时间、住院时间、心脏骤停、心脏压塞和输血。使用随机效应模型汇总结果。纳入了三项共 448 例患者的 RCT。
我们的结果表明，维生素 D 显著降低了 POAF 的发生率（RR：0.60；95%CI：0.40，0.90；p=0.01；I=8%）。还观察到维生素 D 显著缩短了 ICU 入住时间（WMD：-1.639；95%CI：-1.857，-1.420；p<0.00001）。此外，住院时间（WMD：-0.85；95%CI：-2.14，0.43；p=0.19；I=87%）也有所缩短，但结果无统计学意义。
我们的荟萃分析表明，维生素 D 可预防 POAF。需要进行大规模的随机试验来证实我们的结果。
