1.7 X less risk of Heart Failure death if previously had taken any amount of vitamin D

Association between Vitamin D and Heart Failure Mortality in 10,974 Hospitalized Individuals

Nutrients 2021, 13(2), 335; https://doi.org/10.3390/nu13020335

by Kenya Kusunose 1,*ORCID,Yuichiro Okushi 1,Yoshihiro Okayama 2,Robert Zheng 1,Miho Abe 1,Michikazu Nakai 3,Yoko Sumita 3,Takayuki Ise 1,Takeshi Tobiume 1,Koji Yamaguchi 1,Shusuke Yagi 1,Daiju Fukuda 1,Hirotsugu Yamada 4,Takeshi Soeki 1,Tetsuzo Wakatsuki 1 andMasataka Sata 1

A broad range of chronic conditions, including heart failure (HF), have been associated with vitamin D deficiency. Existing clinical trials involving vitamin D supplementation in chronic HF patients have been inconclusive. We sought to evaluate the outcomes of patients with vitamin D supplementation, compared with a matched cohort using real-world big data of HF hospitalization. This study was based on the Diagnosis Procedure Combination database in the Japanese Registry of All Cardiac and Vascular Datasets (JROAD-DPC). After exclusion criteria, we identified 93,692 patients who were first hospitalized with HF between April 2012 and March 2017 (mean age was 79 ± 12 years, and 52.2% were male). Propensity score (PS) was estimated with logistic regression model, with vitamin D supplementation as the dependent variable and clinically relevant covariates.

On PS-matched analysis with 10,974 patients, patients with vitamin D supplementation had

• lower total in-hospital mortality (6.5 vs. 9.4%, odds ratio: 0.67, p < 0.001) and

• in-hospital mortality within 7 days (0.9 vs. 2.5%, OR, 0.34, and

• in-hospital mortality within 30 days 3.8 vs. 6.5%, OR: 0.56 , both p < 0.001)

In the sub-group analysis mortalities in patients with age < 75, diabetes, dyslipidemia, atrial arrhythmia, cancer, renin-angiotensin system blocker, and ß-blocker were not affected by vitamin D supplementation. Patients with vitamin D supplementation had a lower in-hospital mortality for HF than patients without vitamin D supplementation in the propensity matched cohort. The identification of specific clinical characteristics in patients benefitting from vitamin D may be useful for determining targets of future randomized control trials.

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