VINDICATE: Vitamin D3 supplementation improves cardiac function in patients with chronic HF

CHICAGO — One year of vitamin D3 supplementation improves cardiac function in optimally treated patients with chronic HF, researchers reported at the American College of Cardiology Scientific Session.

“We missed our primary efficacy endpoint as a result of the range of variability in the 6-minute walk test, but nevertheless, we saw substantial improvements in left ventricular ejection fraction, LV volumes and LV dimensions,” Klaus K. Witte, MD, FACC, FESC, from the school of medicine, Leeds University and consultant cardiologist at Leeds Teaching Hospitals NHS Trust, England, said during a presentation.

Witte and colleagues randomly assigned 163 patients with HF from the Leeds HF Clinic to 4,000 IU (100 µg) 25-hydroxyvitamin D (cholecalciferol) or a noncalcium placebo. All patients (mean age, 70 years; mean LVEF, 25%) were already on optimal treatment, including beta-blockers, ACE inhibitors and pacemakers, for at least 3 months before enrollment. Treatment continued for 12 months.

Change in 6-minute walk distance between baseline and 12 months was the primary endpoint. Secondary endpoints included change in LVEF at 12 months and safety measures of renal function and serum calcium concentration measured every 3 months.

The vitamin D3 supplementation did not improve 6-minute walk distance (P = .255); however, there was a significant difference in change in cardiac function (LVEF, 6.07%; 95% CI, 3.2-8.95; P < .0001) and a reversal of LV remodeling (LV end diastolic diameter, –2.49 mm; 95% CI, –4.09 to –0.9; P = .002) and LV end systolic diameter (–2.09 mm; 95% CI, –4.11 to –0.06; P = .043) were observed. No significant changes were seen in calcium levels or renal function.

The results were simultaneously published in the Journal of the American College of Cardiology.

“No patients were observed to suffer hypervitaminosis D according to our prespecified safety concentration of 200 nmol/L (80 ng/mL) 25-hydroxyvitamin D, and [no one] required a down-titration of dose,” Witte said.

He also said further studies are needed to investigate whether these improvements in cardiac function translate to improvement in outcomes for patients with HF. – by Tracey Romero

References:

Witte K, et al. Featured Clinical Research II. Presented at: American College of Cardiology Scientific Session; April 2-4, 2016; Chicago.

Witte KK, et al. J Am Coll Cardiol. 2016;doi:10.1016/j.jacc.2016.03.508.

Disclosure: Witte reports no relevant financial disclosures.