Open-Heart Surgery Stress Significantly Reduces Vitamin D Levels

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Aggressive supplementation with vitamin D3 just before and after surgery can completely eliminate the observed drop.

J. Brent Muhlestein, MD, Intermountain Medical Center Heart Institute

J. Brent Muhlestein, MD, Intermountain Medical Center Heart Institute

J. Brent Muhlestein, MD

Open-heart surgery stress significantly reduces patients’ vitamin D levels according to results from a study presented at the 67th American College of Cardiology Annual Scientific Sessions.

In the conducted study, ASSESS-D, researchers found that open-heart surgery patients generally have low levels of vitamin D to begin with, and that stress associated with the surgery further reduced vitamin D levels by discharge.

The Intermountain Medical Center Heart Institute study showed that giving heart patients vitamin D3 supplements before and after surgery reduced those deficiencies, bringing vitamin D levels back to normal.

“Now that we know that the stress from surgery causes vitamin D levels to drop, we want to continue our research and see if supplementing vitamin D levels will help prevent heart problems in the future, given our understanding that low levels of vitamin D can cause an increased risk for heart problems” lead author, J. Brent Muhlestein, MD, cardiovascular researcher, Intermountain Medical Center Heart Institute, said in a statement.

According to researchers, this is an important connection since deficiency of vitamin D is strongly associated with increased risk of myocardial infarctions, strokes, congestive heart failure and other cardiovascular conditions.

Muhlestein and his team studied 150 randomized elective open-heart surgery patients with half receiving 3 daily 50,000-unit doses of vitamin D3 before starting procedures, and the other half placebo.

Patients were monitored for vitamin D levels and major adverse cardiovascular events throughout hospitalization, and then again followed-up with 6 months after surgery.

Vitamin D levels in those who received placebo experienced significantly lower vitamin D levels after open-heart surgery, and among those who received supplementation, vitamin D levels rose into the normal range.

The next step is for researchers to evaluate the effect of vitamin D supplementation on future cardiovascular risk among those who present with myocardial infarction, data which they hope to obtain from the ongoing study Target-D Trial.

In Target-D Trial patients who come in with a myocardial infarction are randomized whether or not to receive long-term vitamin D supplementation. Patients are then followed to determine if the supplements reduce risk of a second myocardial infarction or other complications.

“We need hard evidence, and we hope the Target-D trial will give us real randomized controlled outcomes data to figure out if it’s good to take vitamin D supplements if you’re a heart patient who has low vitamin D levels,” Muhlestein said.

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