What is the clinical evidence from this study?

Study design: RCT. Population: myocardial infarction (n=630). Intervention: Targeted vitamin D3 supplementation vs. Usual care. Primary outcome: Major adverse CV events (composite of death, MI, heart failure hospitalization, and stroke) (HR 0.85, 95% CI 0.58-1.24, p=0.40).

What question did this study set out to answer?

To determine whether targeted vitamin D3 supplementation titrated to achieve specific 25-hydroxyvitamin D levels reduces major adverse cardiovascular events in patients following myocardial infarction.

July 22, 2026European Heart Journal

Targeted vitamin D supplementation and major adverse cardiovascular events after myocardial infarction: the TARGET-D trial

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Key result

Targeted vitamin D supplementation fails to reduce MACE versus usual care in MI patients.

HR 0.85
95% CI 0.58-1.24
P=0.40
n=630

Why the study?

Randomized trials have not demonstrated a reduction in cardiovascular events with vitamin D supplementation, potentially due to fixed or non-targeted dosing strategies.

Does targeted vitamin D3 supplementation reduce major adverse cardiovascular events in patients with myocardial infarction?

Population

630 myocardial infarction patients, median age 63, 78.1% men

Comparison

Targeted vitamin D3 supplementation with titration vs usual care

Design

Pragmatic randomized trial

Follow-up

Average 4.2 ± 2.0 years

Authors

HMHeidi T. May VLViet T Le JAJeffrey L Anderson

Discussion

Member takes

Overview

Targeted vitamin D supplementation does not reduce MACE post-MI; confirms lack of primary-endpoint benefit in this RCT population.

Key Points

To determine whether targeted vitamin D3 supplementation titrated to achieve specific 25-hydroxyvitamin D levels reduces major adverse cardiovascular events in patients following myocardial infarction.
Pragmatic randomized trial (n = 630) conducted between April 2017 and May 2023 with an average follow-up of 4.2 ± 2.0 years.
Participants were randomized to usual care or targeted vitamin D3 supplementation titrated via a dosing algorithm to achieve and maintain a serum 25-hydroxyvitamin D level of >40 to 80 ng/mL.
The primary composite outcome of major adverse cardiovascular events occurred in 15.7% of the vitamin D group versus 18.4% of the usual care group (HR 0.85, 95% CI 0.58–1.24, P = .40).
Secondary outcomes between the vitamin D and usual care groups were 8.9% vs 9.2% for death (HR 0.98, P = .95), 3.8% vs 7.9% for recurrent myocardial infarction (HR 0.48, P = .03), 4.2% vs 3.5% for heart failure hospitalization (HR 1.21, P = .65), and 1.6% vs 0.9% for stroke (HR 1.69, P = .47).

Study Design

Type

RCT (n=630)

Randomization

randomized

Structured PICO

Does targeted vitamin D3 supplementation reduce major adverse cardiovascular events in patients with myocardial infarction?

Population

630 patients with myocardial infarction, 78.1% male, followed for an average of 4.2 years.

Intervention

Targeted vitamin D3 supplementation and ongoing titration based on a dosing algorithm to reach and maintain a target 25(OH)D level of >40-80 ng/mL

Comparator

Usual care

Outcome

Major adverse CV events (composite of death, MI, heart failure hospitalization, and stroke)composite

Main Result

Hazard Ratio: 0.85 (95% CI 0.58–1.24)

Absolute Event Rate: 15.7% vs 18.4%

p-value: p=0.40

Targeted vitamin D supplementation to maintain levels >40-80 ng/mL does not significantly reduce major adverse cardiovascular events in patients with a history of myocardial infarction.

Cite This Study

May et al. (2026) conducted an RCT in myocardial infarction (n=630). Targeted vitamin D3 supplementation vs. Usual care was evaluated on Major adverse CV events (composite of death, MI, heart failure hospitalization, and stroke) (HR 0.85, 95% CI 0.58-1.24, p=0.40). Targeted vitamin D supplementation did not significantly reduce major adverse cardiovascular events compared to usual care among MI patients (15.7% vs 18.4%; HR 0.85; 95% CI 0.58-1.24; P=0.40).

synapsesocial.com/papers/6aa87890f4e52bc8f52c72f3 https://doi.org/10.1093/eurheartj/ehag611

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July 22, 2026European Heart Journal

Targeted vitamin D supplementation and major adverse cardiovascular events after myocardial infarction: the TARGET-D trial

View Full Paper

Ask AI

Bookmark

Key result

Targeted vitamin D supplementation fails to reduce MACE versus usual care in MI patients.

HR 0.85
95% CI 0.58-1.24
P=0.40
n=630

Why the study?

Randomized trials have not demonstrated a reduction in cardiovascular events with vitamin D supplementation, potentially due to fixed or non-targeted dosing strategies.

Does targeted vitamin D3 supplementation reduce major adverse cardiovascular events in patients with myocardial infarction?

Population

630 myocardial infarction patients, median age 63, 78.1% men

Comparison

Targeted vitamin D3 supplementation with titration vs usual care

Design

Pragmatic randomized trial

Follow-up

Average 4.2 ± 2.0 years

Authors

HMHeidi T. May VLViet T Le JAJeffrey L Anderson

Discussion

Member takes

Overview

Targeted vitamin D supplementation does not reduce MACE post-MI; confirms lack of primary-endpoint benefit in this RCT population.

Key Points

To determine whether targeted vitamin D3 supplementation titrated to achieve specific 25-hydroxyvitamin D levels reduces major adverse cardiovascular events in patients following myocardial infarction.
Pragmatic randomized trial (n = 630) conducted between April 2017 and May 2023 with an average follow-up of 4.2 ± 2.0 years.
Participants were randomized to usual care or targeted vitamin D3 supplementation titrated via a dosing algorithm to achieve and maintain a serum 25-hydroxyvitamin D level of >40 to 80 ng/mL.
The primary composite outcome of major adverse cardiovascular events occurred in 15.7% of the vitamin D group versus 18.4% of the usual care group (HR 0.85, 95% CI 0.58–1.24, P = .40).
Secondary outcomes between the vitamin D and usual care groups were 8.9% vs 9.2% for death (HR 0.98, P = .95), 3.8% vs 7.9% for recurrent myocardial infarction (HR 0.48, P = .03), 4.2% vs 3.5% for heart failure hospitalization (HR 1.21, P = .65), and 1.6% vs 0.9% for stroke (HR 1.69, P = .47).

Study Design

Type

RCT (n=630)

Randomization

randomized

Structured PICO

Does targeted vitamin D3 supplementation reduce major adverse cardiovascular events in patients with myocardial infarction?

Population

630 patients with myocardial infarction, 78.1% male, followed for an average of 4.2 years.

Intervention

Targeted vitamin D3 supplementation and ongoing titration based on a dosing algorithm to reach and maintain a target 25(OH)D level of >40-80 ng/mL

Comparator

Usual care

Outcome

Major adverse CV events (composite of death, MI, heart failure hospitalization, and stroke)composite

Main Result

Hazard Ratio: 0.85 (95% CI 0.58–1.24)

Absolute Event Rate: 15.7% vs 18.4%

p-value: p=0.40

Targeted vitamin D supplementation to maintain levels >40-80 ng/mL does not significantly reduce major adverse cardiovascular events in patients with a history of myocardial infarction.

Cite This Study

synapsesocial.com/papers/6aa87890f4e52bc8f52c72f3 https://doi.org/10.1093/eurheartj/ehag611

Also Consider

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