Abstract 18397: Vitamin D Supplementation Prevents Cardiac Failure; MRC RECORD Trial Analysis, Systematic Review And Meta-analysis

Abstract

Objective To assess if vitamin D supplementation, compared to no vitamin D, prevents cardiac failure, MI, stroke or any cardiovascular event through analysis of the MRC RECORD trial, systematic review and meta-analysis.

Methods Trial analysis MRC RECORD was a factorial trial (n=5292) randomising participants to vitamin D3 (800 IU daily) or placebo and calcium or placebo. Primary outcome was low trauma fracture. Three year post-intervention follow up after trial closure resulted in a mean follow up of 6.1 years. Cox proportional hazard model adjusted for age, sex, diabetes, smoking, thiazide use, time since fracture and fracture type, was undertaken to assess time to first MI, stroke, cardiac failure or any cardiovascular event (composite endpoint of cardiac failure, MI and stroke). Systematic review and meta-analysis Three databases and conference abstracts were searched for randomised controlled trials of vitamin D or analogues. Inclusion criteria were mean/median age >60 and >1 year follow up. There were no language restrictions. Authors were contacted for unpublished data. Risk of bias was assessed using Cochrane risk of bias tool. Data were pooled in meta-analysis using random effects model.

Results Trial analysis showed that vitamin D compared with placebo prevented cardiac failure events, but not MI, stroke or any cardiovascular event (table). Meta-analysis included 17 trials (n= 12,440). Nine study authors provided unpublished data. Meta-analysis showed that vitamin D prevented cardiac failure events, but not MI, stroke or any cardiovascular event (table). There was no statistical heterogeneity throughout. Risk of bias was generally low or unclear.

Conclusion This is the first meta-analysis to assess vitamin D and cardiac failure, and the only meta-analysis to include vitamin D cardiovascular events from the large MRC RECORD trial. Vitamin D supplementation was found to prevent cardiac failure events, but not MI, stroke or any cardiovascular event.