Document Detail

Poor outcome in end-stage heart failure patients with low circulating calcitriol levels.
MedLine Citation:
PMID:  18304873     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Vitamin D receptor knockout mice develop typical signs of congestive heart failure (CHF). In approximately 20% of stable CHF patients, frankly low concentrations of the vitamin D hormone calcitriol are found.
AIMS: We investigated whether serum calcitriol concentrations predict clinical outcome in end-stage CHF.
METHODS AND RESULTS: We collected blood samples in 383 end-stage CHF patients who were on a waiting list for cardiac transplantation. We assessed associations of calcitriol with disease severity and freedom from event (death or cardiac transplantation) during 1-year follow-up. In electively listed patients (n=325), 31% had deficient calcitriol levels (<43 pmol/l) compared to 47% in urgently/high urgently listed patients (n=58; P<0.001). As determined by multivariable logistic regression, calcitriol was an independent predictor of the listing status 'urgent/high urgent' (P<0.001). Calcitriol concentrations were also significantly lower in patients with an event (n=233) compared to those who survived on the waiting list (P<0.001). Cox regression analysis revealed that patients in the highest calcitriol tertile had a hazard ratio (95% CI) for an event of 0.506 (0.334-0.767) compared with patients in the lowest calcitriol tertile (P=0.005), after adjustment for potential confounders.
CONCLUSION: Data indicate that low serum calcitriol concentrations are independently associated with poor clinical outcome in end-stage CHF.
Armin Zittermann; Stefanie S Schleithoff; Christian Götting; Oxana Dronow; Uwe Fuchs; Joachim Kuhn; Knut Kleesiek; Gero Tenderich; Reiner Koerfer
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Publication Detail:
Type:  Journal Article     Date:  2008-03-04
Journal Detail:
Title:  European journal of heart failure     Volume:  10     ISSN:  1388-9842     ISO Abbreviation:  Eur. J. Heart Fail.     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-03-11     Completed Date:  2008-08-26     Revised Date:  2011-06-08    
Medline Journal Info:
Nlm Unique ID:  100887595     Medline TA:  Eur J Heart Fail     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  321-7     Citation Subset:  IM    
Klinik für Thorax- und Kardiovaskularchirurgie, Herz- und Diabeteszentrum NRW, Ruhr Universität Bochum, Georgstrasse 11, D-32545 Bad Oeynhausen, Germany.
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MeSH Terms
Calcitriol / blood*
Cross-Sectional Studies
Heart Failure / blood*,  mortality*
Kaplan-Meier Estimate
Logistic Models
Middle Aged
Prospective Studies
Severity of Illness Index
Reg. No./Substance:

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