title: Low-Level Vitamin D Is Associated with Atrial Fibrillation in Patients with Chronic Heart Failure.
abstract: BACKGROUND
  Atrial fibrillation (AF) frequently accompanies heart failure (HF), and causes exacerbation of symptoms and treatment failure in such patients. Vitamin D was recently suggested to be an important mediator of cardiovascular disease, including HF.
  
  
  OBJECTIVE
  The aim of this study was to evaluate the relationship between vitamin D deficiency and AF in patients with chronic HF.
  
  
  METHODS
  The study included 180 chronic HF patients that were divided into 2 groups based on having sinus rhythm [AF (-) group] or chronic AF [AF (+) group]. Vitamin D status was assessed via measurement of the serum 25-hydroxyvitamin D (25[OH]D) concentration.
  
  
  RESULTS
  Mean age of the patients was 66 ± 8.7 years and 53.9% were male. There weren't any significant differences in age, gender, body mass index, etiology or chronic HF stage between the 2 groups. The vitamin D level in the AF (+) group was significantly lower than in the AF (-) group (11.05 ng/mL vs. 20 ng/mL, p < 0.001) and the parathyroid hormone level was significantly higher in the AF (+) group (76.7 vs. 55 pq mL, p < 0.001). The left atrium to body surface area ratio (LA/BSA) was significantly higher in the AF (+) group (45.03 mm/m2 vs. 42.05 mm/m2, p < 0.01). Independent predictors (based on multiple regression) of AF were vitamin D level (OR = 0.854, 95% CI: 0.805-0.907, p < 0.001) and LA/BSA ratio (OR = 1.077, 95% CI: 1.003-1.156, p < 0.05). The optimal vitamin D cut-off value for the prediction of AF was 16.50 ng/mL, with a sensitivity of 76.0% and specificity of 65.5% (AUC = 0.75, 95% CI: 0.67-0.82).
  
  
  CONCLUSIONS
  A low plasma vitamin D concentration was strongly associated with AF in patients with chronic HF.
authors.affiliation: Department of Cardiology, Okmeydanı Training and Research Hospital, Istanbul, Turkey.
authors.forename: Erdal
authors.initials: E
authors.lastname: Belen
authors.affiliation: Department of Cardiology, Ahi Evren Heart and Vascular Surgery Training and Research Hospital, Trabzon, Turkey.
authors.forename: Ahmet C
authors.initials: AC
authors.lastname: Aykan
authors.affiliation: Department of Cardiology, Ahi Evren Heart and Vascular Surgery Training and Research Hospital, Trabzon, Turkey.
authors.forename: Ezgi
authors.initials: E
authors.lastname: Kalaycioglu
authors.affiliation: Department of Cardiology, Kahramanmaras Necip Fazıl State Hospital, Kahramanmaras, Turkey.
authors.forename: Mustafa A
authors.initials: MA
authors.lastname: Sungur
authors.affiliation: Department of Cardiology, Kahramanmaras Necip Fazıl State Hospital, Kahramanmaras, Turkey.
authors.forename: Aylin
authors.initials: A
authors.lastname: Sungur
authors.affiliation: Department of Cardiology, Ahi Evren Heart and Vascular Surgery Training and Research Hospital, Trabzon, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Cetin
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000209:etiology*; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D002908:Chronic Disease; D005260:Female; D006333:Heart Failure / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D018570:Risk Assessment; D012307:Risk Factors; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood / Q000150:complications* / Q000175:diagnosis
chemical_list: D015415:Biomarkers; D014807:Vitamin D; C104450:25-hydroxyvitamin D