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Chronic Heart Failure not treated by Vitamin D, if dose size is ignored – meta-analysis Oct 2015

Vitamin D Supplementation in the Treatment of Chronic Heart Failure: A Meta-analysis of Randomized Controlled Trials.

Clin Cardiol. 2015 Sep 28. doi: 10.1002/clc.22473. [Epub ahead of print]
Jiang WL1, Gu HB2, Zhang YF1, Xia QQ1, Qi J3, Chen JC2.

VitaminDWiki comment and references
  • Many meta-analyses of vitamin D fail to account for dose size.
  • The worst example was another meta-analysis which ignored dose sizes which ranged from 20 IU to 5,000 IU daily.
    If a similar meta-analysis were done for aspirin, it would ignore the dose size differences of response from 13 mg to 325 mg

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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.

PMID: 26415519

Attached files

ID Name Comment Uploaded Size Downloads
6070 CHF Meta T1.jpg admin 20 Oct, 2015 16:31 108.53 Kb 1090
6069 Jiang_et_al-2015-Clinical_Cardiology.pdf PDF 2015 admin 20 Oct, 2015 16:19 1.18 Mb 515
6068 CHF Meta 2.jpg admin 20 Oct, 2015 16:18 38.71 Kb 666
6067 CHF Meta.jpg admin 20 Oct, 2015 16:18 42.28 Kb 671
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