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Vitamin D analogue may benefit valve-replacement surgery patients

24 Feb 2021

For patients undergoing valve-replacement surgery, early treatment with alfacalcidol is well tolerated and may shorten the duration of intensive care unit (ICU) stay, a study has found.

Most critically ill patients are vitamin-D deficient, and vitamin D deficiency may contribute to worse prognosis and prolonged hospital length of stay (LOS). Those receiving open-heart surgery are especially at risk due to the associated life-threatening postoperative complications. Therefore, the study examined the effect of treatment with alfacalcidol 2 μg/d started 48 h before surgery and continued throughout the hospital stay.

A total of 89 adult patients undergoing valve-replacement surgery were randomized to receive the vitamin D analogue (n=47) or no treatment (n=42). All of them were also given cefazolin antibiotic prophylaxis, stress ulcer prophylaxis, analgesics, and anticoagulation prophylaxis with subcutaneous enoxaparin and warfarin.

Eighty-six patients were included in the final analysis, with 51 (59.3 percent) being vitamin D deficient on hospital admission. Alfacalcidol produced a marked reduction in ICU LOS (hazard ratio [HR], 1.61, 95 percent confidence interval [CI], 1.77–2.81; p=0.041) and hospital LOS (HR, 1.63, 95 percent CI, 1.04–2.55; p=0.034).

Compared with controls, treated patients had much lower postoperative infection rate (35.5 percent vs 56.1 percent; p=0.017) and median epinephrine dose (5.9 vs 8.2 mg; p=0.019).

There was no significant difference in the rate of in-hospital mortality.

The findings suggest that alfacalcidol may be beneficial via its immunomodulatory and cardioprotective properties.

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Most Read Articles
Jairia Dela Cruz, 28 Apr 2020
Laparoscopic tubal reanastomosis yields better pregnancy outcomes and may be more cost-effective than in-vitro fertilization (IVF) treatment in women who wish to conceive after tubal ligation surgery, according to a Singapore study.
Pearl Toh, 15 Sep 2020
Use of a levonorgestrel intrauterine device (IUD) can help reduce menstrual bleeding in adolescents with disabilities — thus providing an option for menstrual management in this population with special needs, in whom data on IUD use are lacking.
Elvira Manzano, 10 Jun 2020
Men with HIV who are on testosterone therapy appear to have an elevated risk for significant coronary artery calcium progression (CAC) vs those who are not on it, according to a study released at CROI 20.
Stephen Padilla, 11 Sep 2018
Use of diclofenac, a traditional nonsteroidal anti-inflammatory drug (NSAID) with cyclo-oxygenase-2 (COX-2) selectivity similar to COX-2 inhibitors, is associated with higher cardiovascular health risk compared with nonuse, paracetamol use and use of other traditional NSAIDs, a recent study has shown.