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Heart Failure and Vitamin D meta-analyses - 2016, 2018


Vitamin D is as good as conventional drugs at treating Chronic Heart Failure Meta-analysis Jan 2016

Vitamin D Supplementation in the Treatment of Chronic Heart Failure: A Meta-analysis of Randomized Controlled Trials
Clin Cardiol. 2016 Jan;39(1):56-61. doi: 10.1002/clc.22473. Epub 2015 Sep 28.
Jiang WL1, Gu HB2, Zhang YF1, Xia QQ1, Qi J3, Chen JC2.

BACKGROUND: In recent years, there has been growing evidence that vitamin D deficiency is associated with the development and progression of chronic heart failure (CHF).

HYPOTHESIS: Additional supplementation of vitamin D may have protective effects in patients with CHF.

METHODS:
We searched PubMed, Embase, and Cochrane databases through June 2015 and included 7 randomized controlled trials that investigated the effects of vitamin D on cardiovascular outcomes in patients with CHF. Then, we performed a meta-analysis of clinical trials to confirm whether vitamin D supplementation is beneficial in CHF patients. The weighted mean difference (WMD) and 95% confidence interval (CI) were calculated using fixed- or random-effects models.

RESULTS:
Our pooled results indicated that additional supplementation of vitamin D was not superior to conventional treatment in terms of left ventricular ejection fraction, N-terminal pro-B-type natriuretic peptide, and 6-minute walk distance. Moreover, vitamin D supplementation was associated with significant decreases in the levels of tumor necrosis factor-α (WMD: -2.42 pg/mL, 95% CI: -4.26 to -0.57, P < 0.05), C-reactive protein (WMD: -0.72 mg/L, 95% CI: -1.42 to -0.02, P < 0.05), and parathyroid hormone (WMD: -13.44 pg/mL, 95% CI: -21.22 to -5.67, P < 0.05).

CONCLUSIONS: Vitamin D supplementation may decrease serum levels of parathyroid hormone and inflammatory mediators in CHF patients, whereas it has no beneficial effects on improvement of left ventricular function and exercise tolerance.
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Vitamin D helps remodeling after HF - meta-analysis Aug 2018

Effect of vitamin D on ventricular remodelling in heart failure: a meta-analysis of randomised controlled trials.
BMJ Open. 2018 Aug 30;8(8):e020545. doi: 10.1136/bmjopen-2017-020545.
Zhao JD1, Jia JJ1, Dong PS1, Zhao D1, Yang XM1, Li DL1, Zhang HF1.

OBJECTIVES: The level of vitamin D is considered to be associated with the development and progression of heart failure (HF). However, it is still unclear whether supplementation of vitamin D could improve ventricular remodelling in patients with HF. This study aimed to systematically evaluate the influence and safety of additional vitamin D supplementation on ventricular remodelling in patients with HF.

DESIGN: This study is a meta-analysis of randomised controlled trials (RCTs).

SETTING: The PubMed, EMBASE, CNKI, Cochrane library, Web of Science databases and grey literature were searched for RCTs regarding the effect of vitamin D on ventricular remodelling in patients with HF (from database creation to October 2017). RevMan V.5.3 software was employed for data analysis.

PARTICIPANTS: Seven RCTs with a total of 465 patients, including 235 cases in the vitamin D group and 230 cases in the control group, were included.

PRIMARY AND SECONDARY OUTCOME MEASURES: Left ventricular end-diastolic dimension (LVEDD), left ventricular ejection fraction (LVEF) and the incidence of adverse reactions.

RESULTS:
Compared with the control group, a decrease in the LVEDD (mean difference (MD)=-2.31 mm, 95% CI -4.15 to -0.47, p=0.01) and an increase in the LVEF (MD=4.18%, 95% CI 0.36 to 7.99, p=0.03) were observed in the vitamin D group. Subgroup analysis also revealed a reduced LVEDD in adults (>18 years) and adolescents (<18 years) of the vitamin D group relative to that in those of the control group. High-dose vitamin D (>4000 IU/day) was more effective at reducing the LVEDD than low-dose vitamin D (<4000 IU/day). Moreover, vitamin D supplementation was more effective at reducing the LVEDD and increasing the LVEF in patients with reduced ejection fraction than in patients without reduced ejection fraction.

CONCLUSION: Vitamin D supplementation inhibits ventricular remodelling and improves cardiac function in patients with HF.

TRIAL REGISTRATION NUMBER: CRD42017073893.
 Download the PDF from VitaminDWiki


See also VitaminDWiki


Studies in both VitaminDWiki categories Cardiovascular and Meta-analysis:

Created by admin. Last Modification: Wednesday January 30, 2019 23:20:59 GMT-0000 by admin. (Version 8)

Attached files

ID Name Comment Uploaded Size Downloads
11203 CoQ10 treats heart failure - Review July 2018.pdf PDF 2018 admin 14 Jan, 2019 16:11 516.10 Kb 11
11202 Chronic Heart Failure 2016.pdf admin 14 Jan, 2019 16:07 1.16 Mb 6
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