Key result
Preoperative vitamin D supplementation cuts POAF ~56% in patients with significant deficiency.
Why the study?
Postoperative atrial fibrillation is a common complication after cardiovascular surgery, and vitamin D is suggested to have potential cardioprotective effects.
Does preoperative vitamin D supplementation reduce postoperative atrial fibrillation in vitamin D deficient patients undergoing cardiac surgery?
Meta-Analysis
Does preoperative vitamin D supplementation reduce postoperative atrial fibrillation in vitamin D deficient patients undergoing cardiac surgery?
Odds Ratio: 0.44 (95% CI 0.3–0.64)
p-value: p=<0.001
Preoperative vitamin D supplementation may reduce the incidence of postoperative atrial fibrillation in patients with significant vitamin D deficiency undergoing cardiac surgery, though evidence certainty is low.
Preoperative vitamin D repletion may lower POAF in deficient cardiac surgery patients; confirms benefit in this subgroup and warrants dedicated RCTs.
Introduction Postoperative atrial fibrillation (POAF) is a common complication following cardiovascular surgeries, including CABG. Vitamin D is suggested to have potential cardioprotective effects. This systematic review and meta-analysis aims to evaluate the effect of preoperative vitamin D supplementation on POAF and related biomarkers in patients with moderate to severe vitamin D deficiency. Methods The main databases, including Pubmed, Web of Science, Scopus, and the Cochrane Central Library, were searched up to February 2025 for randomized controlled trials (RCTs) that evaluated the effect of vitamin D supplementation on POAF. A meta-analysis was conducted to assess the impact of preoperative vitamin D supplementation on POAF and associated biomarkers. A dose-response analysis was performed to determine the relationship between vitamin D dose and supplementation duration with POAF risk. Sensitivity analyses were conducted to assess the robustness of the findings. Results A total of 4 studies met the eligibility criteria and were included. The meta-analysis revealed that preoperative vitamin D supplementation significantly reduced the risk of POAF (OR: 0.44; 95 % CI: 0.30–0.64; p < 0.001, I² = 0.00) among patients with significant vitamin D deficiency (baseline levels between 10 and 14 ng/mL in all included trials). Vitamin D supplementation did not result in a statistically significant difference in CRP, hemoglobin, left atrial size, ejection fraction, or length of hospital stay. Risk-of-bias assessment showed generally low risk across most domains, with some concerns related to blinding and selective reporting, resulting in low certainty of evidence based on GRADE. Conclusion Among vitamin D deficient patients, pre-CABG vitamin D supplementation may be associated with a lower incidence of POAF; however, the certainty of evidence is low due to limitations in the available randomized trials, including concerns related to blinding, reporting, and imprecision. Therefore, these findings should be interpreted with caution and should not be generalized to individuals with normal vitamin D levels. Further well-designed, adequately powered randomized controlled trials are required to confirm these observations and clarify the clinical role of preoperative vitamin D supplementation in this setting.
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Heshmati et al. (2026) conducted a meta-analysis in Postoperative atrial fibrillation following cardiac surgery. Preoperative vitamin D supplementation was evaluated on Postoperative atrial fibrillation (POAF) (OR 0.44, 95% CI 0.30-0.64, p=<0.001). Preoperative vitamin D supplementation significantly reduced the risk of postoperative atrial fibrillation in patients with significant vitamin D deficiency (OR 0.44; 95% CI 0.30-0.64; p<0.001).
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