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Review
. 2023 Mar 21;15(3):e36496.
doi: 10.7759/cureus.36496. eCollection 2023 Mar.

The Role of Vitamin D Supplementation Before Coronary Artery Bypass Grafting in Preventing Postoperative Atrial Fibrillation in Patients With Vitamin D Deficiency or Insufficiency: A Systematic Review and Meta-Analysis

Saad Ali Ansari  1 , Jasninder Singh S Dhaliwal  1 , Yusra Ansari  2 , Sudeshna Ghosh  1 , Tahir Muhammad Abdullah Khan  3
Affiliations
Review

The Role of Vitamin D Supplementation Before Coronary Artery Bypass Grafting in Preventing Postoperative Atrial Fibrillation in Patients With Vitamin D Deficiency or Insufficiency: A Systematic Review and Meta-Analysis

Saad Ali Ansari et al. Cureus. .

Abstract

This study aims to evaluate the role of preoperative vitamin D supplementation before coronary artery bypass grafting (CABG) surgery in preventing postoperative atrial fibrillation (POAF) in vitamin D deficient or insufficient patients. Three randomized controlled trials (RCTs) comprising 448 subjects were selected after a detailed search was conducted on PubMed, Cochrane CENTRAL, Scopus, and Embase in December 2022. Analysis was run using RevMan (version 5.4.1; Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2014). The analysis collected risk ratio (RR) and 95% confidence interval (CI) data from the relevant studies, which were then pooled using a random effects model. A significance level of less than 0.05 (p<0.05) was considered significant. Our analysis showed that compared with the standard of care, preoperative vitamin D supplementation in vitamin D deficient and insufficient patients effectively reduced POAF after CABG surgery (RR=0.6, 95% CI=0.4-0.9, P=0.01). There was no significant difference in the duration of hospitalization between the vitamin D supplementation group compared with the control following CABG (mean difference -0.85, 95% CI -2.13 to 0.43, P = 0.19). This meta-analysis shows that preoperative vitamin D supplementation in vitamin D deficient and insufficient patients undergoing CABG can reduce the rate of POAF. As POAF is associated with many complications, providing vitamin D supplementation to individuals with a vitamin D deficiency undergoing CABG can improve long-term cardiovascular outcomes following surgery.

Keywords: arrhythmia; coronary artery bypass grafting (cabg); post operative complication; post-operative atrial fibrillation; vitamin d supplementation.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. PRISMA flowchart for selection of studies
PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-analyses
Figure 2
Figure 2. Forest plot comparing vitamin D supplementation with no vitamin D supplementation in preventing postoperative atrial fibrillation in vitamin D deficient or insufficient patients undergoing coronary artery bypass grafting.
Source: References [8-10]
Figure 3
Figure 3. Forest plot of mean difference in length of hospitalization between vitamin D supplementation group compared with control.
Source: References [8-10]
See this image and copyright information in PMC

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