Universität zu Köln

Zittermann, Armin, Ernst, Jana B., Prokop, Sylvana, Fuchs, Uwe, Dreier, Jens, Kuhn, Joachim, Knabbe, Cornelius, Birschmann, Ingvild, Schulz, Uwe, Berthold, Heiner K., Pilz, Stefan ORCID: 0000-0002-7959-1311, Gouni-Berthold, Ioanna, Gummert, Jan F., Dittrich, Marcus and Boergermann, Jochen (2017). Effect of vitamin D on all-causemortality in heart failure (EVITA): a 3-year randomized clinical trial with 4000 IU vitamin D daily. Eur. Heart J., 38 (29). S. 2279 - 2287. OXFORD: OXFORD UNIV PRESS. ISSN 1522-9645

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Abstract

Aims Circulating 25-hydroxyvitamin D (25OHD) levels <75 nmol/L are associated with a nonlinear increase in mortality risk. Such 25OHD levels are common in heart failure (HF). We therefore examined whether oral vitamin D supplementation reduces mortality in patients with advanced HF. Methods and results Four hundred HF patients with 25OHD levels <75 nmol/L were randomized to receive 4000 IU vitamin D daily or matching placebo for 3 years. Primary endpoint was all-cause mortality. Key secondary outcome measures included hospitalization, resuscitation, mechanical circulatory support (MCS) implant, high urgent listing for heart transplantation, heart transplantation, and hypercalcaemia. Initial 25OHD levels were on average <40 nmol/L, remained around 40 nmol/L in patients assigned to placebo and plateaued around 100 nmol/L in patients assigned to vitamin D. Mortality was not different in patients receiving vitamin D (19.6%; n = 39) or placebo (17.9%; n = 36) with a hazard ratio (HR) of 1.09 [95% confidence interval (CI): 0.69-1.71; P = 0.726]. The need for MCS implant was however greater in patients assigned to vitamin D (15.4%, n = 28) vs. placebo [9.0%, n = 15; HR: 1.96 (95% CI: 1.04-3.66); P = 0.031]. Other secondary clinical endpoints were similar between groups. The incidence of hypercalcaemia was 6.2% (n = 10) and 3.1% (n = 5) in patients receiving vitamin D or placebo (P = 0.192). Conclusion A daily vitamin D dose of 4000 IU did not reduce mortality in patients with advanced HF but was associated with a greater need for MCS implants. Data indicate caution regarding long-term supplementation with moderately high vitamin D doses.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Zittermann, Armin UNSPECIFIED UNSPECIFIED UNSPECIFIED Ernst, Jana B. UNSPECIFIED UNSPECIFIED UNSPECIFIED Prokop, Sylvana UNSPECIFIED UNSPECIFIED UNSPECIFIED Fuchs, Uwe UNSPECIFIED UNSPECIFIED UNSPECIFIED Dreier, Jens UNSPECIFIED UNSPECIFIED UNSPECIFIED Kuhn, Joachim UNSPECIFIED UNSPECIFIED UNSPECIFIED Knabbe, Cornelius UNSPECIFIED UNSPECIFIED UNSPECIFIED Birschmann, Ingvild UNSPECIFIED UNSPECIFIED UNSPECIFIED Schulz, Uwe UNSPECIFIED UNSPECIFIED UNSPECIFIED Berthold, Heiner K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Pilz, Stefan UNSPECIFIED orcid.org/0000-0002-7959-1311 UNSPECIFIED Gouni-Berthold, Ioanna UNSPECIFIED UNSPECIFIED UNSPECIFIED Gummert, Jan F. UNSPECIFIED UNSPECIFIED UNSPECIFIED Dittrich, Marcus UNSPECIFIED UNSPECIFIED UNSPECIFIED Boergermann, Jochen UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-223112
DOI:	10.1093/eurheartj/ehx235
Journal or Publication Title:	Eur. Heart J.
Volume:	38
Number:	29
Page Range:	S. 2279 - 2287
Date:	2017
Publisher:	OXFORD UNIV PRESS
Place of Publication:	OXFORD
ISSN:	1522-9645
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language D SUPPLEMENTATION; D DEFICIENCY; CALCIUM; ASSOCIATION; RISK; TRANSPLANTATION; PREVENTION; MORTALITY; SOCIETY; DISEASE Multiple languages Cardiac & Cardiovascular Systems Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/22311