TY - JOUR
T1 - Vitamin D supplementation, cardiac events and stroke
T2 - A systematic review and meta-regression analysis
AU - Nudy, Matthew
AU - Krakowski, George
AU - Ghahramani, Mehrdad
AU - Ruzieh, Mohammed
AU - Foy, Andrew J.
N1 - Publisher Copyright:
© 2020
PY - 2020/6
Y1 - 2020/6
N2 - Introduction: Observational data has suggested a link between vitamin D deficiency and coronary heart disease (CHD). However, randomized controlled trials (RCTs) have failed to show benefit. The objective of this study is to analyze the RCTs investigating vitamin D supplementation and the risk of CHD and stroke. Methods: All RCTs that compared vitamin D supplementation to placebo and evaluated nonfatal myocardial infarction (MI), cardiac mortality, stroke and CHD events (a composite of cardiac mortality, MI, unstable angina and revascularization) were included. Rate ratios (RR) were calculated for each endpoint and to test for heterogeneity of treatment effect (HTE) the Chi2 and I2 tests were used for younger vs. older participants, shorter vs. longer trial duration, vitamin D supplements with vs. without calcium, and daily vs. monthly dosages of vitamin D. A meta-regression was performed with baseline vitamin D concentration as the covariate. Results: 22 RCTs were identified (n = 83,200). Vitamin D supplementation had no effect on nonfatal MI (RR 0.98, 95% confidence interval (CI) 0.89–1.08), cardiac death (RR 0.94, CI 0.84–1.06), CHD events (RR 1.00, CI 0.91–1.10), or stroke (RR, 0.97, CI 0.9–1.03). When performing the meta-regression with baseline circulating 25-hydroxyvitamin D (25(OH)D) concentrations as the covariate, vitamin D supplementation's treatment effect on CVD outcomes was not associated with baseline 25(OH)D. Conclusion: Vitamin D did not reduce CHD and stroke. A linear relationship does not exist between baseline 25(OH)D and vitamin D supplementation's effect on CVD. Vitamin D levels should be checked and repleted in those with an absolute indication.
AB - Introduction: Observational data has suggested a link between vitamin D deficiency and coronary heart disease (CHD). However, randomized controlled trials (RCTs) have failed to show benefit. The objective of this study is to analyze the RCTs investigating vitamin D supplementation and the risk of CHD and stroke. Methods: All RCTs that compared vitamin D supplementation to placebo and evaluated nonfatal myocardial infarction (MI), cardiac mortality, stroke and CHD events (a composite of cardiac mortality, MI, unstable angina and revascularization) were included. Rate ratios (RR) were calculated for each endpoint and to test for heterogeneity of treatment effect (HTE) the Chi2 and I2 tests were used for younger vs. older participants, shorter vs. longer trial duration, vitamin D supplements with vs. without calcium, and daily vs. monthly dosages of vitamin D. A meta-regression was performed with baseline vitamin D concentration as the covariate. Results: 22 RCTs were identified (n = 83,200). Vitamin D supplementation had no effect on nonfatal MI (RR 0.98, 95% confidence interval (CI) 0.89–1.08), cardiac death (RR 0.94, CI 0.84–1.06), CHD events (RR 1.00, CI 0.91–1.10), or stroke (RR, 0.97, CI 0.9–1.03). When performing the meta-regression with baseline circulating 25-hydroxyvitamin D (25(OH)D) concentrations as the covariate, vitamin D supplementation's treatment effect on CVD outcomes was not associated with baseline 25(OH)D. Conclusion: Vitamin D did not reduce CHD and stroke. A linear relationship does not exist between baseline 25(OH)D and vitamin D supplementation's effect on CVD. Vitamin D levels should be checked and repleted in those with an absolute indication.
UR - http://www.scopus.com/inward/record.url?scp=85084827069&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85084827069&partnerID=8YFLogxK
U2 - 10.1016/j.ijcha.2020.100537
DO - 10.1016/j.ijcha.2020.100537
M3 - Article
C2 - 32462077
AN - SCOPUS:85084827069
SN - 2352-9067
VL - 28
JO - IJC Heart and Vasculature
JF - IJC Heart and Vasculature
M1 - 100537
ER -