Atrial fibrillation after cardiac surgery and preoperative vitamin D levels: A systematic review and meta-analysis

Öztürk, Selen

doi:10.5606/tgkdc.dergisi.2020.18387

Cited by 8 publications

(6 citation statements)

References 39 publications

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“…One of the most important mechanisms is activation of the renin–angiotensin–aldosterone system. A meta-analysis conducted by Öztürk et al ( 55 ) found a significant relationship between the preoperative level of VitD and AF after cardiac surgery ( p < 0.05). Those results were consistent with those of our study, but pooled results had great heterogeneity.…”

Section: Discussionmentioning

confidence: 99%

Association Between the Circulating Level of 25-Hydroxyvitamin D and Clinical Results After Cardiac Surgery: A Meta-Analysis and Systematic Review

Zhang

Qiu

et al. 2021

Front. Cardiovasc. Med.

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Background: Vitamin D (VitD) is an important pleiotropic hormone for organ systems. Studies have focused on the level of VitD, especially that of 25-hydroxyvitamin D (25-(OH)-VitD), in patients after cardiac surgery and the relationship between VitD deficiency and adverse outcomes, but the results have been inconsistent. We carried out a meta-analysis to evaluate differences in the 25-(OH)-VitD level before and after cardiac surgery, and evaluated the predictive value of 25-(OH)-VitD level in the clinical outcomes of patients undergoing cardiac surgery.Methods: Studies related to VitD level and cardiac surgery were searched from PubMed, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials databases from inception to October 2020. We applied the Newcastle–Ottawa Scale to assess the risk of a bias in individual studies. We examined the heterogeneity and publication bias and performed subgroup analyses and sensitivity analyses.Results: Fifteen studies were included in our analysis. The 25-(OH)-VitD level was significantly lower immediately after surgery [stand mean difference (SMD), 0.69; 95%CI (0.1, 1.28), P = 0.023] and 24-h after surgery [0.84; (0.47, 1.21), 0.000] compared with that before surgery. A higher prevalence of 25-(OH)-VitD deficiency was recorded 24 h after surgery [RR, 0.59; 95%CI (0.47, 0.73), P = 0.00]. Pooled results demonstrated a significant relationship between the preoperative 25-(OH)-VitD level and vasoactive-inotropic score (VIS) [SMD, −3.71; 95%CI (−6.32, −1.10); P = 0.005], and patients with 25-(OH)-VitD deficiency revealed a comparatively poor prognosis and severe condition after cardiac surgery [−0.80; (−1.41, −0.19), 0.01]. However, 25-(OH)-VitD deficiency was not associated with the duration of stay in the intensive care unit.Conclusions: Cardiac surgery would leads to deficiency of 25-(OH)-VitD. And the preoperative and postoperative levels of 25-(OH)-VitD are associated with adverse events, which is eligible to work as an indicator to demonstrate clinical outcomes.

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Section: Discussionmentioning

confidence: 99%

Association Between the Circulating Level of 25-Hydroxyvitamin D and Clinical Results After Cardiac Surgery: A Meta-Analysis and Systematic Review

Zhang

Qiu

et al. 2021

Front. Cardiovasc. Med.

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“…Moreover, 1, 25(OH) 2 D has exhibited an inhibitory effect on the renin‐angiotensin system, while vitamin D deficiency may activate the aforementioned system 27,28 . Several systematic reviews and meta‐analyses have concluded that vitamin D deficiency increases the risk of AF and POAF 29,30 . Furthermore, a dose–response meta‐analysis demonstrated that increasing vitamin D levels reduces the incidence of AF and POAF 31 .…”

Section: Discussionmentioning

confidence: 99%

“…27,28 Several systematic reviews and meta-analyses have concluded that vitamin D deficiency increases the risk of AF and POAF. 29,30 Furthermore, a dose-response meta-analysis demonstrated that increasing vitamin D levels reduces the incidence of AF and POAF. 31 Interestingly, several epidemiological studies have demonstrated a higher prevalence of AF in winter, which may imply the role of vitamin D. 32,33 Furthermore, the level of vitamin D after CABG, among POAF group was less than those without this complication.…”

Section: Discussionmentioning

confidence: 99%

The effects of vitamin D supplementation on postoperative atrial fibrillation after coronary artery bypass grafting in patients with vitamin D deficiency

Talasaz

Salehiomran

Heidary

et al. 2022

Journal of Cardiac Surgery

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Introduction: Postoperative atrial fibrillation (POAF) as a common complication of coronary artery bypass grafting (CABG) surgery is associated with increased mortality and morbidity rates. Vitamin D deficiency increases the prevalence of POAF; however, the effects of vitamin D supplementation on the incidence of POAF have not yet been completely elucidated. Methods: In this prospective, open-label, randomized clinical trial the level of 25-hydroxy vitamin D (25(OH) D) was measured in patients undergoing CABG surgery. Patients with vitamin D insufficiency (defined as 25(OH) D level < 30 ng/ml)were included and randomly assigned to control group to receive either the general standard of care (Group A) or to study group to receive the general standard of care plus oral vitamin D 3 , 600,000 IU 5 days before surgery (Group B). The primary outcome of our study was the occurrence of POAF during the first 5 days after CABG surgery.Results: Totally, 93 patients in group B and 103 patients in group A completed the study. The occurrence of POAF was significantly lower in group B as compared to group A (9.68% vs. 20.39%, p = .038). The length of intensive care unit (ICU) stay and hospital stay were reduced in group B patients (2.21 vs. 3.86 days, p < .001 and 7.40 vs. 9.58 days, p = .022, respectively). Conclusion:Our study demonstrated that vitamin D supplementation reduces the incidence of POAF, duration of ICU, and hospital stay following CABG surgery.

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“…Although two meta-analyses 15,27 did not found a significant link, a meta-analysis with more subjects found vitamin D deficiency to be associated with atrial fibrillation. 18 Two systematic reviews and meta-analyses 28,29 were published addressing the same question. Neither of the studies did pay attention to the timing of vitamin D measurement.…”

Section: Discussionmentioning

confidence: 99%

“…Two systematic reviews and meta-analyses 28 , 29 were published addressing the same question. Neither of the studies did pay attention to the timing of vitamin D measurement.…”

Section: Discussionmentioning

confidence: 99%

The relationship between preoperative serum vitamin D deficiency and postoperative atrial fibrillation: A systematic review and meta-analysis

Rahimi

Taban-Sadeghi

Nikniaz

et al. 2021

J Cardiovasc Thorac Res

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Postoperative atrial fibrillation (POAF) is the most common arrhythmia seen in the first days following cardiac surgeries. Recently, there is a growing discussion regarding the link between vitamin D deficiency and POAF development. This systematic review and meta-analysis of the observational studies aimed at evaluating the association between preoperative vitamin D deficiency and Postoperative atrial fibrillation. In this study, using PubMed, Scopus, Google Scholar, EMBASE, Web of Science, and Cochrane Libraries, we searched for records published before July 2020. Two reviewers screened for studies that examined the relationship between preoperative vitamin D levels and the generation of POAF. Data regarding study design, patient characteristics, definition of atrial fibrillation (AF) , type of surgery, vitamin D levels, and measurement methods were extracted. Five studies were included in the meta-analysis. Our primary analysis showed a significant relationship between preoperative levels of vitamin D and POAF development (mean differences (MD) = -2.851, 95% confidence interval (CI) =-5.506 to -0.195; P value 0.035). Our meta-analysis suggested serum vitamin D deficiency is associated with an increased risk of POAF development. Further large scale interventional studies are needed to explore whether vitamin D supplementation will prevent POAF.

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Atrial fibrillation after cardiac surgery and preoperative vitamin D levels: A systematic review and meta-analysis

Cited by 8 publications

References 39 publications

Association Between the Circulating Level of 25-Hydroxyvitamin D and Clinical Results After Cardiac Surgery: A Meta-Analysis and Systematic Review

Association Between the Circulating Level of 25-Hydroxyvitamin D and Clinical Results After Cardiac Surgery: A Meta-Analysis and Systematic Review

The effects of vitamin D supplementation on postoperative atrial fibrillation after coronary artery bypass grafting in patients with vitamin D deficiency

The relationship between preoperative serum vitamin D deficiency and postoperative atrial fibrillation: A systematic review and meta-analysis

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