Vitamin D Deficiency Is a Predictor of Mortality in Elderly with Chronic Heart Failure.

CONTEXT: The prevalence of both heart failure and vitamin D deficiency increases with age and is associated with poor outcome in the elderly.

OBJECTIVES

We aimed to investigate the relationship between all-cause mortality and vitamin D deficiency in elderly patients with chronic heart failure.

DESIGN

It is a retrospective, observational cross-sectional study. Median follow-up time was 497 days.

SUBJECTS AND

METHODS

302 patients aged ≥65 years heart failure patients was categorized into tertiles based on the 25-hydroxy-vitamin D levels. Clinical and laboratory parameters were evaluated according to tertiles. Hospitalization rates and overall survival were compared between tertiles. Independent predictors of all cause mortality were defined.

RESULTS

Patients with low vitamin D tertile were mostly women (p=0.001), and had a worse NYHA functional class (p=0.005). During follow-up, deaths were more frequent in the first tertile (p = 0.001). All-cause mortality increased significantly with decreasing vitamin D tertiles (from third tertile 7.9%, to 11.9%, to 26%; log rank test p=0.003). No significant difference was observed at the composite endpoint of mortality or HF hospitalizations (P=0.451). Multivariate analysis supported that low vitamin D concentration was an independent predictor of all causes of mortality (HR 0.93; 95% CI 0.89-0.97; p=0.004).

CONCLUSIONS

Low vitamin D levels were independent predictors of all-cause mortality in the elderly population with chronic heart failure.