Vitamin D Deficiency Is Associated with Increased Clinical and Financial Burden of Acute Decompensated Heart Failure
Abhishek Chaturvedi1, Anastasios Kapetanos1, Thomas Robertson1, Parul Chandrika4, Muhammad Salman Faisal1, Mario Castagnaro1, Tarun Sharma2, Craig Alpert3, Amresh Raina3. 1Internal Medicine, Allegheny General Hospital, Pittsburgh, Pennsylvania, United States, 2Rheumatology, Allegheny Health Network, Pittsburgh, Pennsylvania, United States, 3Cardiology, Allegheny Health Network, Pittsburgh, Pennsylvania, United States, 4Internal Medicine, East Carolina University Hospital, Greenville, North Carolina, United States
Purpose of Study Epidemiologic and animal studies have suggested potential link between low vitamin D levels (VDD) and cardiovascular risk.Although some studies have explored associations of VDD with CAD and stroke, the association of acute decompensated heart failure (ADHF) in VDD is unknown. We sought to determine the prevalence of ADHF in VDD and whether VDD is associated with increased clinical and financial burden of ADHF using the National Inpatient Sample (NIS) from 2012 to 2014.
Methods Used Patients aged >18years with principle diagnosis of ADHF were identified using the ICD9 codes 428* and those with VDD using codes 268* in NIS database. Demographics, traditional risk factors, and ADHF-related outcomes were identified in VDD patients and compared to the general population. Primary outcome was risk of ADHF, and secondary outcomes were increased length of stay i.e; ≥5 days (ILOS) and increased hospital charges i.e; ≥$20,000 (IHC) for ADHF related hospitalizations.
Summary of Results From 2012 through 2014, a total of 90million weighted hospitalizations were divided into VDD (1.2million) and general population. VDD patients were older and more likely female (Table 1). Prevalence of DM, hypertension (HTN), dyslipidemia (HLD), and CAD, as well as rates of ADHF hospitalizations; and proportion of ILOS and IHC were significantly higher in VDD. On regression analysis, VDD was associated with increased odds of ADHF beyond adjustment for age, gender, race, DM, HTN, HLD, CAD, tobacco and alcohol use [OR: 1.04 (1.02-1.07), p=0.002]. Moreover, VDD was also associated with ILOS [OR: 1.30 (1.24-1.37), <0.001] and IHC [OR: 1.13 (1.07-1.20), <0.001] even after adjustment for above factors as well as household income and insurance status.
Conclusions Our findings reveal that vitamin D deficiency may be a potential cardiovascular risk factor in heart failure. As it is easily supplemented, further elucidating this relationship could have important public health implications. Controlled interventional trials are warranted to confirm our findings.
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