Alfacalcidol beneficial to patients undergoing valve-replacement surgery

Supplementation with alfacalcidol prior to valve-replacement surgery helps accelerate cardiac recovery, leading to shorter length of stay in the intensive care unit (ICU) and the hospital, according to a study.

The study involved 89 adult patients who were randomized to receive either alfacalcidol 2 μg/d 48 hours before surgery and continued throughout the hospital stay (intervention group, n=47) or no supplementation (control group, n=42).

A total of 86 patients were included in the final analysis, among whom 51 (59.3 percent) had vitamin D deficiency on hospital admission. Results for the primary endpoints were significantly better in the intervention than the control group. The corresponding hazard ratios were 1.61 (95 percent confidence interval [CI], 1.77–2.81) for the length of ICU stay (p=0.041) and 1.63 (95 percent CI, 1.04–2.55) for the length of hospital stay (p=0.034).

Supplementation was also associated with a markedly lower postoperative infection rate (35.5 percent vs 56.1 percent; p=0.017).

The median epinephrine dose was lower in the intervention than the control group (5.9 vs 8.2 mg; p=0.019). On the other hand, the rate of in-hospital mortality was similar.

Vitamin D deficiency is prevalent following major cardiac surgeries and is associated with poor prognosis and prolonged length of hospital stay. The effect of supplementation with alfacalcidol on outcomes of patients undergoing valve-replacement surgery may be attributed to its immunomodulatory and cardioprotective mechanisms.