Vitamin D status and outcomes in heart failure patients
Liu LC, Voors AA, van Veldhuisen DJ, van der Veer E, Belonje AM, Szymanski MK, Silljé HH, van Gilst WH, Jaarsma T, de Boer RA
European journal of heart failure · 127 citas
Etiquetas de revisión
Financiación no declaradaDatos neutrales que nuestra revisión registró sobre cómo se hizo este estudio. Describen el método, nunca si nos gusta el resultado.
Cómo se estudió
- Diseño
- Ensayo controlado aleatorizado (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Eventos clínicos como enfermedad o muerte
Quién lo pagó
- Financiación
- Financiación no declarada
Publicación
- Publicado
- 2011-05-04 · Eur J Heart Fail · vol. 13 · número 6 · págs. 619–625
- Editorial
- Elsevier BV
- Citado
- 166 citas · más que el 98% de estudios similares · 8.6× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 33 trabajos
- Acceso
- De pago
- Áreas de investigación
- Vitamin D Research Studies · Heart Failure Treatment and Management · Dialysis and Renal Disease Management
- Palabras clave
- 25-hydroxyvitamin D, heart failure, prognosis, all-cause mortality, heart failure readmission, renin-angiotensin system, plasma renin activity, C-reactive protein, interleukin-6, inflammation, NT-proBNP, vitamin D supplementation, sex differences, elderly patients, left ventricular ejection fraction
- MeSH
- humans, vitamin d deficiency, renin, vitamin d, c-reactive protein, interleukin-6, prognosis, treatment outcome, risk factors, cohort studies, renin-angiotensin system, aged, aged, 80 and over, middle aged, female, male, heart failure
10 autores
- Licette C.Y. Liu🇳🇱University Medical Center Groningen; University of Groningen
- Adriaan A. Voors🇳🇱University Medical Center Groningen; University of Groningen
- Dirk Jan van Veldhuisen🇳🇱University Medical Center Groningen; University of Groningen
- Eveline van der Veer🇳🇱University Medical Center Groningen; University of Groningen
- Anne M.S. Belonje🇳🇱University Medical Center Groningen; University of Groningen
- Mariusz K. Szymanski🇳🇱University Medical Center Groningen; University of Groningen
- Herman H.W. Silljé🇳🇱University Medical Center Groningen; University of Groningen
- Wiek H. van Gilst🇳🇱University Medical Center Groningen; University of Groningen
- Tiny Jaarsma🇳🇱University Medical Center Groningen; University of Groningen
- Rudolf A. de Boer🇳🇱 · autor de correspondenciaUniversity Medical Center Groningen; University of Groningen
Resumen
El texto original del estudio, en el idioma en que se publicó.
Aims
Vitamin D status has been implicated in the pathophysiology of heart failure (HF). The aims of this study were to determine whether a low vitamin D status is associated with prognosis in HF and whether activation of the renin-angiotensin system (RAS) and inflammatory markers could explain this potential association.
Methods and results
We measured 25-hydroxy-vitamin D (25(OH)D), plasma renin activity (PRA), interleukin-6 (IL-6), C-reactive protein (CRP), and the incidence of death or HF rehospitalization in 548 patients with HF. Median age was 74 (64-80) years, left ventricular ejection fraction was 30% (23-42), and mean follow-up was 18 months. Low 25(OH)D levels were associated with female gender (P< 0.001), higher age (P= 0.002), and higher N-terminal pro-brain natriuretic peptide (NT-proBNP) levels (P< 0.001). Multivariable linear regression analysis showed that PRA (P= 0.048), and CRP levels (P= 0.006) were independent predictors of 25(OH)D levels. During follow-up, 155 patients died and 142 patients were rehospitalized. Kaplan-Meier analysis showed that lower 25(OH)D concentration was associated with an increased risk for the combined endpoint (all-cause mortality and HF rehospitalization; log rank test P= 0.045) and increased risk for all-cause mortality (log rank test P= 0.014). After adjustment in a multivariable Cox regression analysis, low 25(OH)D concentration remained independently associated with an increased risk for the combined endpoint [hazard ratio (HR) 1.09 per 10 nmol/L decrease; 95% confidence interval (CI) 1.00-1.16; P= 0.040] and all-cause mortality (HR 1.10 per 10 nmol/L decrease; 95% CI 1.00-1.22; P= 0.049).
Conclusion
A low 25(OH)D concentration is associated with a poor prognosis in HF patients. Activation of the RAS and inflammation may confer the adverse effects of low vitamin D levels.
Resumen vía Europe PMC. Los derechos de autor siguen siendo de los autores o la editorial.
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