title: Effect of Vitamin D and calcium supplementation on ischaemic stroke outcome: a randomised controlled open-label trial.
abstract: OBJECTIVE
  Vitamin D deficiency is a common problem in stroke survivors. Observational studies have reported an association of low vitamin D levels with greater stroke severity, poststroke mortality and functional disability. Randomised clinical trials are lacking. We sought to assess the effect of calcium and vitamin D supplementation in ischaemic stroke survivors with vitamin D deficiency/insufficiency on disability/mortality outcomes.
  
  
  METHODS
  In this randomised controlled open-label trial, 73 patients of acute ischaemic stroke were screened for serum 25 hydroxy Vitamin D (25(OH)D) levels. A total of 53 patients with baseline 25(OH)D <75 nmol/L were randomised into two arms. One received vitamin D and calcium supplementation along with usual care (n=25) and the other received usual care alone (n=28). Primary outcome was the proportion of patients achieving a good outcome [modified Rankin Scale score 0-2] at 6 months and all cause mortality at 6 months.
  
  
  RESULTS
  The age (mean±SD) of participants was 60.4±11.3 years, 69.8% were males. The proportion of patients achieving good outcome was higher in the intervention arm (Adjusted OR 1.9, 95% CI 0.6-6.4; P=.31). The survival probability was greater in the intervention arm (83.8%, CI 62.4-93.6) as compared with the control arm (59.5%, CI 38.8-75.2; P=.049) with adjusted Hazard ratio (HR) of 0.26 (95% CI 0.08-0.9; P=.03).
  
  
  CONCLUSIONS
  This is the first randomised controlled study assessing the effect of vitamin D and calcium supplementation on ischaemic stroke outcomes and points towards a potential benefit. Findings need to be validated by a larger trial.
authors: Department of Neurology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors: Anu
authors: A
authors: Gupta
authors: Department of Neurology, Postgraduate Institute of Medical Education and Research, Chandigarh, India. sudeshprabhakar@gmail.com.
authors: Sudesh
authors: S
authors: Prabhakar
authors: Department of Neurology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors: Manish
authors: M
authors: Modi
authors: Department of Endocrinology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors: Sanjay K
authors: SK
authors: Bhadada
authors: Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India.
authors: Mani
authors: M
authors: Kalaivani
authors: Department of Neurology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors: Vivek
authors: V
authors: Lal
authors: Department of Neurology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors: Dheeraj
authors: D
authors: Khurana
mesh_terms: D002545:Brain Ischemia / Q000097:blood / Q000178:diet therapy* / Q000401:mortality; D002136:Calcium, Dietary / Q000008:administration & dosage*; D019587:Dietary Supplements; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D020521:Stroke / Q000097:blood / Q000178:diet therapy* / Q000401:mortality; D016896:Treatment Outcome; D014807:Vitamin D / Q000008:administration & dosage* / Q000031:analogs & derivatives / Q000097:blood; D014808:Vitamin D Deficiency / Q000178:diet therapy* / Q000401:mortality; D014815:Vitamins / Q000008:administration & dosage*
chemical_list: D002136:Calcium, Dietary; D014815:Vitamins; D014807:Vitamin D; C104450:25-hydroxyvitamin D