Effect of preoperative vitamin D on postoperative atrial fibrillation incidence after coronary artery bypass grafting

Gen Thorac Cardiovasc Surg. 2024 Mar 15. doi: 10.1007/s11748-024-02020-2. Online ahead of print.

Abstract

Background: Post-operative atrial fibrillation (POAF) is associated with adverse long-term cardiovascular events.

Objectives: This study investigated the effects of a high-dose vitamin D administered preoperatively on the postoperative atrial fibrillation (POAF) incidence in patients with vitamin D deficiency following coronary artery bypass grafting (CABG) surgery.

Methods: This randomized controlled clinical trial was conducted on 246 CABG patients with vitamin D deficiency. All patients were randomly divided into intervention and control groups including 123 cases for each group. In the intervention group, from 3 days before surgery, they received a daily dose of 150,000 units of vitamin D orally (50,000 units of Vit D tablet three times a day) and the patients in the control group received placebo tablets before surgery. All patients in the intervention group were assessed continuously for the occurrence of POAF during the recovery period.

Results: In terms of gender, age, and BMI there were no significant differences between intervention and control groups. Our findings showed that the use of vitamin D supplements did not cause a significant change in the duration of intubation and hospitalization. The ratio of POAF following CABG surgery in the control and treatment groups was 26% and 11.4%, respectively (odds ratio = 0.36; 95% CI = 0.18-0.72; P = 0.003).

Conclusions: Our findings revealed that high-dose vitamin D supplementation before CABG surgery significantly reduced the incidence of POAF. Further multicenter randomized trials with larger sample sizes are certainly warranted to confirm our results.

Keywords: Coronary artery bypass grafting (CABG); Postoperative atrial fibrillation (POAF); Vitamin D deficiency.