Document Detail


Inorganic phosphate and FGF-23 predict outcome in stable systolic heart failure.
MedLine Citation:
PMID:  22150123     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Eur J Clin Invest 2011 ABSTRACT: Background  Recent studies show associations between inorganic phosphate and risk of heart failure in the general population as well as between fibroblast growth factor 23 (FGF-23) and outcome in coronary heart disease. This study was carried out to assess whether circulating levels of inorganic phosphate and FGF-23, a new central hormone in mineral bone metabolism, predict outcome in systolic heart failure. Materials and methods  Ninety-nine consecutive outpatients with systolic heart failure were enrolled. Mean (SD) age was 61 years (11), mean left ventricular ejection fraction (LVEF) was 33% (10), 82 patients were men, median estimated creatinine clearance was 83 mL/min (Q(1) -Q(3) 58-106), median NTproBNP level was 803 pg/mL (Q(1) -Q(3) 404-2757), median inorganic phosphate was 1·12 mM (Q(1) -Q(3) 1·02-1·22), median FGF-23 was 39·02 pg/mL (Q(1) -Q(3) 32·45-55·86) and median follow-up was 35 months. Associations between inorganic phosphate, FGF-23 and endpoints were assessed using Cox regression analyses. Results  Inorganic phosphate and FGF-23 levels were significantly higher (P < 0·001 and P = 0·009) in patients reaching the combined endpoint of cardiac hospitalization or death. FGF-23 (ln) predicted all-cause mortality (hazard ratio (HR) 5·042, P = 0·032) in a model adjusted for age, gender, estimated creatinine clearance, LVEF, New York Heart Association (NYHA) stage and NTproBNP level. Inorganic phosphate predicted heart failure hospitalization (HR 26·944, P = 0·021), cardiac hospitalization (HR 16·016, P = 0·017) and the combined endpoint (HR 13·294, P = 0·015) in models adjusted for the same co-variables. Conclusion  The results of this study demonstrate the independent prognostic value of inorganic phosphate and FGF-23 in heart failure even in the context of established risk markers.
Authors:
Max Plischke; Stephanie Neuhold; Christopher Adlbrecht; Bernhard Bielesz; Sascha Shayganfar; Christian Bieglmayer; Thomas Szekeres; Walter H Hörl; Guido Strunk; Patrick Vavken; Richard Pacher; Martin Hülsmann
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-11-16
Journal Detail:
Title:  European journal of clinical investigation     Volume:  -     ISSN:  1365-2362     ISO Abbreviation:  -     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-12-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0245331     Medline TA:  Eur J Clin Invest     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2011 The Authors. European Journal of Clinical Investigation © 2011 Stichting European Society for Clinical Investigation Journal Foundation.
Affiliation:
Division of Nephrology and Dialysis, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria Division of Cardio-Thoracic-Vascular Anaesthesia and Intensive Care Medicine, Department of Anaesthesia, Medical University of Vienna, Vienna, Austria Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Vienna, Vienna, Austria Research Institute for Health Care Management and Economics, Vienna University of Economics and Business, Vienna, Austria Department of Orthopedic Surgery, Children's Hospital Boston, Harvard Medical School, Boston, MA, USA Center for Population and Development Studies, Harvard School of Public Health, Boston, MA, USA.
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