Risk of AFib after Cardiac surgery cut in half by 200,000+ IU Vitamin D meta-analysis
Preventive Effect of Preoperative Vitamin D Supplementation on Postoperative Atrial Fibrillation Following Cardiac Surgery: A Systematic Review and Dose-Response Meta-Analysis - March 2026
Introduction: Postoperative atrial fibrillation (POAF) is a common complication following cardiovascular surgeries, including CABG. Vitamin D is suggested to have potential cardioprotective effects. This systematic review and meta-analysis aims to evaluate the effect of preoperative vitamin D supplementation on POAF and related biomarkers in patients with moderate to severe vitamin D deficiency. Methods: The main databases, including MEDLINE, Web of Science, Scopus, and the Cochrane Central Library, were searched up to February 2025 for randomized controlled trials (RCTs) that evaluated the effect of vitamin D supplementation on poAF. A meta-analysis was conducted to assess the impact of preoperative vitamin D supplement, non on POAF and associated biomarkers. A dose-response analysis was performed to determine the relationship between vitamin D dose and supplementation duration with PC*F risk. Sensitivity analyses were conducted to assess the robustness of the findings.
Results: The meta-analysis revealed that preoperative vitamin D supplementation significantly reduced the risk of POA F (OR: 0.44; 95% CI: 0.30-0.64; p < 0.001, I2 = 0.00) among patients with significant vitamin D deficiency (baseline levels between 10 and 14 ng/mL in all included trials). Vitamin D supplementation did not result in a statistically significant difference in CRP, hemoglobin, left atrial size, ejection fraction, or length of hospital stay.
Conclusion: Among vitamin D deficient patients, pre-CABG vitamin D supplementation may be associated with a lower incidence of POAF; however, the certainty of evidence is low due to limitations in the available randomized trials, including concerns related to blinding, reporting, and imprecision. Therefore, these findings should be interpreted with caution and should not be generalized to individuals with normal vitamin D levels. Further well-designed, adequately powered randomized controlled trials are required to confirm these observations and clarify the clinical role of preoperative vitamin D supplementation in this setting.
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