PARIS – Patients with severe vitamin D deficiency who underwent vascular surgery faced a significant, 56% increased risk for developing a cardiovascular event during the 30 days following surgery compared with patients who had a sufficient vitamin D level, in a review of 269 patients treated at a single Dutch center.
The study findings did not address whether patients who were vitamin D deficient and then received a vitamin D supplement had a reduced number of postsurgical events, Dr. Koen M. van de Luijtgaarden and his associates from Erasmus University Medical Center in Rotterdam, The Netherlands reported in a poster at the meeting.
The study also documented the frequency of vitamin D deficiency or insufficiency in patients scheduled for vascular surgery. Of the 269 patients included in the review who underwent vascular surgery during 2008-2010 at Erasmus Medical Center, 78 (29%) had a sufficient plasma level of vitamin D at baseline, defined as a 25-hydroxyvitamin D level of greater than 75 nmol/L. In all 38 of the patients (14%) had severe vitamin D deficiency at baseline, defined as 25 nmol/L or less. A total of 76 (28%) had moderate deficiency, defined as more than 25 nmol/L to 50 nmol/L, and 77 (29%) had vitamin D insufficiency, defined as more than 50 nmol/L to 75 nmol/L.
About two-thirds of the surgery patients were men, and the average age of all patients in the review was 66.
The primary endpoint of the study was the rate of cardiovascular events during the first 30 days after surgery, a composite tally that included the rates of cardiovascular deaths, nonfatal myocardial damage, or stroke. The incidence of these events was 38% in the severely deficient patients, 24% in patients with moderate deficiency, 32% in patients with vitamin D insufficiency, and 13% in those with a sufficient level of the vitamin.
In a multivariate analysis that controlled for baseline differences in demographics, medical history, and medications, patients in the severely deficient group had a statistically significant, 56% increased incidence of cardiovascular events, compared with patients with a sufficient vitamin D level. Patients with moderate deficiency or insufficiency both showed trends toward more events compared with the sufficient group, but in neither case was the difference statistically significant.
The findings are consistent with prior reports that vitamin D deficiency links with an increased risk for atherosclerosis and cardiovascular events, said Dr. van de Luijtgaarden, a researcher in the department of vascular surgery at Erasmus, and his associates.
Dr. van de Luijtgaarden said that he and his associates had no disclosures.