Abstract
Postoperative atrial fibrillation (POAF) is the most common arrhythmia seen in the first days following cardiac surgeries. Recently, there is a growing discussion regarding the link between vitamin D deficiency and POAF development. This systematic review and meta-analysis of the observational studies aimed at evaluating the association between preoperative vitamin D deficiency and Postoperative atrial fibrillation. In this study, using PubMed, Scopus, Google Scholar, EMBASE, Web of Science, and Cochrane Libraries, we searched for records published before July 2020. Two reviewers screened for studies that examined the relationship between preoperative vitamin D levels and the generation of POAF. Data regarding study design, patient characteristics, definition of atrial fibrillation (AF), type of surgery, vitamin D levels, and measurement methods were extracted. Five studies were included in the meta-analysis. Our primary analysis showed a significant relationship between preoperative levels of vitamin D and POAF development (mean differences (MD) = -2.851, 95% confidence interval (CI) =-5.506 to -0.195; P value 0.035). Our meta-analysis suggested serum vitamin D deficiency is associated with an increased risk of POAF development. Further large scale interventional studies are needed to explore whether vitamin D supplementation will prevent POAF.
Highlights
As the most common arrhythmia in the first days following cardiac surgeries[1], atrial fibrillation(AF) is seen in 0.51% of the worldwide population and has faced a 33% rise in its prevalence through recent two decades.[2]
Five studies with 219 AF cases and 669 participants were included in this systematic review
All of the studies examined the link between serum vitamin D levels measured before surgery and Postoperative atrial fibrillation (POAF) in patients undergoing cardiac surgeries
Summary
As the most common arrhythmia in the first days following cardiac surgeries[1], atrial fibrillation(AF) is seen in 0.51% of the worldwide population and has faced a 33% rise in its prevalence through recent two decades.[2] This arrhythmia, increasing cerebral emboli up to 50%, is an important cause of morbidity and mortality in elder patients.[3] Postoperative atrial fibrillation (POAF) is mostly seen in the first 4 days after surgery.[4] Combined valve and coronary artery bypass surgery has the highest prevalence of POAF (60%-80%) among different types of cardiac surgery.[5] Systemic and pericardial inflammation, tune changes in the autonomic nervous system and oxidative stress are examples of physiological disorders in cardiac surgeries thought to be possible stimulators for POAF.[6] recently there is a growing discussion on the role of vitamin D in POAF development
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