Vitamin D not tied to fibrillation

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By Linda Thrasybule

NEW YORK | Fri Sep 16, 2011 5:19pm EDT

NEW YORK (Reuters Health) - Despite some research linking low vitamin D levels to heart disease, a new study suggests that lacking D does not increase one's risk of an irregular heartbeat known as atrial fibrillation.

Researchers followed nearly 3,000 middle-aged and older adults in the long-running Framingham Heart Study for roughly 10 years and found that 425 people developed atrial fibrillation.

But, Dr. Michiel Rienstra of Massachusetts General Hospital and his colleagues found there was no difference in the likelihood of getting the condition between people with the highest vitamin D levels in their blood and those with the lowest.

Atrial fibrillation stems from a malfunction in the heart's electrical system, which causes the irregular heartbeat. That can lead blood to pool in the heart, increasing the risk of blood clots, which in turn may cause strokes. Treatment often includes blood thinners taken to prevent clots.

"I think the study was done well," said Dr. Michal Melamed, who studies vitamin D at the Einstein School of Medicine in New York and was not involved in the research. It shows that this one vitamin doesn't have an effect on all heart diseases, which is a good thing, she said.

A 2008 study of the same group of Framingham participants found that vitamin D levels were associated with an increased risk of cardiovascular disease.

"We think that low vitamin D affects the architecture of the heart, but I'm not sure that it affects the electrical system of the heart," Melamed told Reuters Health.

Published in the American Heart Journal, the study included roughly equal numbers of men and women, ranging in age between about 54 and 76.

A recent review by the U.S. Institute of Medicine concluded that most Americans get sufficient vitamin D and that there's insufficient evidence consuming much higher amounts would offer any greater health benefits.

Whether people should consider vitamin D important for their heart health is still controversial, said Dr. Emelia Benjamin of the Boston University School of Medicine, who worked with Rienstra on the new research. "There's a lot of speculation and it's still undergoing study."

SOURCE: bit.ly/niHaJQ American Heart Journal, September 2011.

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HEALTH MANAGEMENT. Operations (Rivaroxaban) recommended for patients with non-valvular atrial fibrillation, United States

Anticoagulant Rivaroxaban (rivaroxaban) has been recommended by the FDA's cardiovascular Renal Drugs Advisory Committee for the prevention of systemic embolism and stroke in patients with non-valvular AF (atrial fibrillation). The Committee, also known as the Panel, voted 9 to 2 in favour, with 1 abstention.
The FDA (food and Drug Administration) is expected to make a final decision on September 8th. The Panel's verdict is not binding; the FDA can ignore the recommendation if it so wishes. However, this rarely happens.
Bayer Healthcare holds the rights to sell rivaroxaban outside the United States, while Janssen Pharmaceuticals, Inc. has the rights to market it inside the United States. Janssen is a Johnson & Johnson company.
Janssen had submitted to the NDA (new drug application) for rivaroxaban in the United States on January 5th this year for the prevention of stroke and systemic embolism in individuals with non-valvular AF.
Bayer has submitted rivaroxaban for market authorization for the same indication as well as DVT treatment and the prevention of recurrent DVT and PE to the European Medicines Agency (EMA). A submission has also been presented to Japanese authorities.
Rivaroxaban was approved recently for blood clot prevention after some orthopedic surgical procedures. Having approval for stroke will give access to a much greater number of patients Janssen.
Warfarin has been used for stroke prevention for over 50 years. With warfarin, doctors need to regularly measure its levels in the bloodstream, which is not the case with Rivaroxaban. However, warfarin is far cheaper.
According to Bayer and Janssen, Rivaroxaban is more convenient for patients, and has fewer side effects.
The heart has two upper chambers - the atria, and two lower chambers - the ventricles. The atria consist of a right and left atrium, and the ventricles are called the left and right ventricle. When the atria contract too rapidly and / or may, the patient has atrial fibrillation. Atrial fibrillation is the most common type of arrhythmia, which is caused when there is a disorder in the heart's electrical system. Arrhythmia is a problem with the speed or rhythm of the heartbeat.
AT affects over 6 million Europeans, more than 2.3 million Americans, and approximately 800,000 patients in Japan.
AT patients are vulnerable to the formation of blood clots in the atria. The clot can make its way through the bloodstream to the brain, where it can cause a stroke. Strokes can lead to brain damage, which in turn can result in serious physical and behavioral problems and even death.
On individual with AT is five times more likely to have a stroke compared to the general population. In fact, about one-third of AT patients do suffer a stroke.

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