The effects of vitamin D (Vit-D) deficiency and Vit-D treatment (VDT) on atrial fibrillation
(AF) remain inconclusive. This study sought to determine the effects of VDT and nontreatment
on AF risk in Vit-D–deficient patients without a previous history of AF. In this nested
case-control study, 39,845 individuals with low 25-hydroxy-Vit-D ([25-OH]D) levels
(<20 ng/ml) were divided into group-A (untreated, levels ≤20 ng/ml), group-B (treated,
levels 21 to 29 ng/ml), and group-C (treated, levels ≥30 ng/ml). The risk of AF was
compared utilizing propensity score–weighted Cox proportional hazard models. Among
the individuals receiving VDT for ≥6 months, the risk of AF was significantly lower
in group-B (hazard ratio [HR] 0.89, 95% confidence interval [CI] 0.80 to 0.98, p = 0.03]
and group-C (HR 0.84, 95% CI 0.73 to 0.0.95, p = 0.007] than in group-A. A subgroup
analysis of men >65 years showed individuals with hypertension had a significantly
lower risk of AF in group-C than in group-B (HR 0.79, CI 0.65 to 0.94, p = 0.02) and
group-A (HR 0.78, CI 0.64 to 0.96, p = 0.012). A similar result was found in men >65 years
with diabetes mellitus in group-C compared with group-B (HR 0.69, CI 0.51 to 0.93,
p = 0.012) and group-A (HR 0.63, CI 0.47 to 0.84, p = 0.002). In what is, to best
of our knowledge, the largest observational study to date of patients with Vit-D deficiency
and no previous history of AF, (25-OH)D level of >20 ng/ml with VDT for ≥6 months
was associated with a significantly lower risk of AF. Additionally, men >65 years
with hypertension or diabetes mellitus had a further decrease in AF risk when the
(25-OH)D levels were ≥30 ng/ml.
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Article info
Publication history
Published online: March 31, 2022
Received in revised form:
February 21,
2022
Received:
December 14,
2021
Identification
Copyright
Published by Elsevier Inc.
