Vitamin D deficiency increases the risk of poor brain function after sudden cardiac arrest by seven-fold, according to research presented at Acute Cardiovascular Care 2014 by Dr Jin Wi from Korea. Vitamin D deficiency also led to a higher chance of dying after sudden cardiac arrest.

Acute Cardiovascular Care is the annual meeting of the Acute Cardiovascular Care Association (ACCA) of the European Society of Cardiology (ESC) and takes place 18-20 October in Geneva, Switzerland.

Dr Wi said: "In patients resuscitated after sudden cardiac arrest, recovery of neurological function is very important, as well as survival. Vitamin D deficiency has been reported to be related to the risk of having various cardiovascular diseases, including sudden cardiac arrest. We investigated the association of vitamin D deficiency with neurologic outcome after sudden cardiac arrest, a topic on which there is no information so far."

The researchers prospectively analysed clinical data from all unconscious patients resuscitated from sudden cardiac arrest of presumed cardiac cause at Severance Cardiovascular Hospital in Seoul, Korea. Neurologic outcome was assessed by the Cerebral Performance Category (CPC) score at 6 months after discharge.1 Good neurologic outcome was defined as a CPC score of 1 or 2, whereas poor neurological outcome was defined as a CPC score of 3 to 5. Vitamin D deficiency was defined as 25-hydroxyvitamin D less than 10 ng/mL.

The study included 53 patients. Bystander cardiopulmonary resuscitation (CPR) was performed in 41 patients (77%). The first monitored heart rhythm was shockable in 36 patients (68%) and non-shockable in 17 patients (32%). The average vitamin D level was 10.3 ng/mL and 31 patients (59%) were deficient.

Patients with a poor neurological outcome had a significantly lower vitamin D level (7.9 ng/mL) compared to those with a good neurological outcome (12.4 ng/mL) (p=0.002). The researchers found that 65% of patients with vitamin D deficiency had a poor neurological outcome at 6 months after discharge compared to 23% of patients with healthy vitamin D levels. They also found that 29% of patients with vitamin D deficiency had died at 6 months compared to none of the patients with good vitamin D levels (p=0.007).


Dr Wi said: "Patients with vitamin D deficiency were more likely to have a poor neurological outcome or die after sudden cardiac arrest than those who were not deficient. Nearly one-third of the patients who were deficient in vitamin D had died 6 months after their cardiac arrest, whereas all patients with sufficient vitamin D levels were still alive."

The researchers conducted a multivariate logistic analysis to assess the impact of a number of factors on neurological outcome after sudden cardiac arrest. They found that vitamin D deficiency independently predicted poor neurological outcome with an odds ratio of 7.13.

Dr Wi said: "Vitamin D deficiency increased the risk of poor neurological outcome after sudden cardiac arrest by 7-fold. The only factors that had a greater impact on poor neurological outcome were the absence of bystander CPR or having a first monitored heart rhythm that was non-shockable."

He added: "Our findings suggest that vitamin D deficiency should be avoided, especially in people with a high risk of sudden cardiac arrest. People are at higher risk if they have a personal or family history of heart disease including heart rhythm disorders, congenital heart defects and cardiac arrest. Other risk factors for cardiac arrest include smoking, obesity, diabetes, a sedentary lifestyle, high blood pressure and high cholesterol, and drinking too much alcohol."

Dr Wi continued: "Vitamin D is found in oily fish, such as salmon, sardines, and mackerel, eggs, fortified fat spreads, fortified breakfast cereals and powdered milk. Most of our vitamin D stores are made by the body when our skin reacts to sunlight."

He concluded: "A large randomised clinical trial is needed to find out whether supplements of vitamin D can protect high risk groups from having a sudden cardiac arrest.

Aspirin may double the chances of survival for patients with gastrointestinal cancers, according to the results of a new study recently presented at the 2015 European Cancer Congress in Vienna, Austria.



This research, led by Dr. Martine Frouws of Leiden University Medical Centre in the Netherlands, adds to growing evidence suggesting aspirin may be useful in the prevention and treatment of cancer.

Last month, Medical News Today reported on a study suggesting aspirin may reduce the risk of colorectal cancer, while a more recent study claims aspirin may help boost treatment response in patients with breast, skin and bowel cancers.

For their study, Dr. Frouws and colleagues set out to determine how aspirin impacts the survival of patients with tumors in the gastrointestinal (GI) tract - namely the rectum, colon and esophagus. This is the first time a study has simultaneously assessed survival data by different GI locations, according to the authors.

The study included 13,715 patients who received a GI cancer diagnosis between 1998 and 2011. They were followed up for a median of 48.6 months. Of these patients, 42.8% had colon cancer, 25.4% had rectal cancer and 10.2% had cancer of the esophagus.

To determine how aspirin use after a GI cancer diagnosis impacted the overall survival of these patients, the researchers linked patient data with drug dispensing information from the PHARMO Institute in Utrecht, the Netherlands.

"In this study we analyzed each separate prescription per patient, and therefore we were able to achieve a more exact estimate of the effect of aspirin on cancer survival," notes Dr. Frouws.
Post-diagnosis aspirin users twice as likely to survive GI cancer

Overall, around 30.5% of patients used aspirin prior to GI cancer diagnosis, 8.3% only used aspirin after their diagnosis, while 61.1% did not use aspirin.


Across all cancers, around 28% of patients survived for at least 5 years.

Compared with patients who used aspirin before their cancer diagnosis and those who did not use the medication, patients who used aspirin after their diagnosis were twice as likely to survive, according to the results.

This finding remained even after the team accounted for potential confounding factors, including age, sex, cancer stage, cancer treatment and the presence of other medical conditions.

While the exact mechanism underlying the anticancer effect of aspirin is unclear, the researchers suggest it could be down to its antiplatelet properties. They explain that circulating tumor cells (CTCs) are believed to use platelets - a component of blood - to shield themselves from the immune system. Because aspirin blocks the function of platelets, this may expose CTCs, leaving them open to attack.

Though the optimal dosage and duration of aspirin use and its effect on GI cancers need to be investigated in further research, the team believes they have uncovered a potential treatment option that could reach a wide number of patients.

"Given that aspirin is a cheap, off-patent drug with relatively few side effects, this will have a great impact on health care systems as well as patients," says Dr. Frouws, adding:

blood test used to determine whether a heart is suitable for donation may be leading to unnecessary rejections, and its use should be reviewed. This is the conclusion of a new study published in the journal Circulation: Heart Failure.

Heart failure occurs when the heart is unable to pump enough oxygen-rich blood around the body to help other organs function.

According to the Centers for Disease Control and Prevention (CDC), in the United States, around 5.7 million Americans have heart failure.

In some cases, heart failure can be treated with lifestyle changes - such as a healthy diet, exercise, and quitting smoking - and medications. For end-stage heart failure, however, a heart transplant may be the only option.

According to the United Network for Organ Sharing (UNOS), as of June 10, 2016, there are 4,147 people in the U.S. waiting for a heart transplant.

However, according to Dr. Snehal R. Patel, assistant professor of medicine at Albert Einstein College of Medicine's Montefiore Medical Center in New York, NY, more than half of these patients will not receive a transplant.

"A lot of focus has been on finding ways to sign up more people as organ donors, but there is also a problem in that only an average of 1 in 3 donor hearts are placed," he adds.

In many heart transplant centers, the blood of potential donors is routinely tested for levels of troponin I - a protein that is released in response to heart damage.

Dr. Patel explains that if troponin I levels are high, then a donor heart will often be rejected out of concern that the organ is too damaged to function following transplantation - regardless of whether the heart appears healthy.

Donor troponin I levels do not affect recipient survival

For their study, the researchers assessed the outcomes of 10,943 heart transplant recipients aged 18 and older using data from UNOS. All donor hearts had normal pumping function, the authors note.

The team set out to determine whether there are any differences in outcomes for patients who received a heart from a donor with high troponin I levels.

At 30 days, 1 year, 3 years, and 5 years after heart transplantation, the researchers found no significant differences in survival between recipients whose donors had high troponin I levels and those whose levels were normal.

There was also no association between donor troponin I levels and risk of recipient death 1 year after transplantation, the researchers report.

Additionally, donor troponin I levels made no difference to recipients' incidence of primary graft failure - loss of pumping action that occurs within 30 days of transplantation - and cardiac allograft vasculopathy - a form of heart disease that can limit long-term survival following heart transplantation.

Based on their findings, Dr. Patel and colleagues believe heart transplant centers should make decisions about whether a heart is suitable for transplantation based exclusively on donor troponin I levels.