Open-Heart Surgery Stress Significantly Reduces Vitamin D Levels

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

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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