Parathormone levels add prognostic ability to N-terminal pro-brain natriuretic peptide in stable coronary patients
Aims: There are controversial data on the ability of the components of mineral metabolism (vitamin D, phosphate, parathormone [PTH], fibroblast growth factor-23 [FGF23], and klotho) to predict cardiovascular events. In addition, it is unknown whether they add any prognostic value to other well-known...
| Autores: | , , , , , , , , , , , , , , , , , , , |
|---|---|
| Tipo de recurso: | artículo |
| Fecha de publicación: | 2021 |
| País: | España |
| Institución: | Universidad Autónoma de Madrid |
| Repositorio: | Biblos-e Archivo. Repositorio Institucional de la UAM |
| Idioma: | inglés |
| OAI Identifier: | oai:repositorio.uam.es:10486/705140 |
| Acceso en línea: | http://hdl.handle.net/10486/705140 https://dx.doi.org/10.1002/ehf2.13331 |
| Access Level: | acceso abierto |
| Palabra clave: | Coronary artery disease Fibroblast growth factor-23 Mineral metabolism Parathormone Medicina |
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España |
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| dc.title.none.fl_str_mv |
Parathormone levels add prognostic ability to N-terminal pro-brain natriuretic peptide in stable coronary patients |
| title |
Parathormone levels add prognostic ability to N-terminal pro-brain natriuretic peptide in stable coronary patients |
| spellingShingle |
Parathormone levels add prognostic ability to N-terminal pro-brain natriuretic peptide in stable coronary patients Gutiérrez-Landaluce, Carlos Coronary artery disease Fibroblast growth factor-23 Mineral metabolism Parathormone Medicina |
| title_short |
Parathormone levels add prognostic ability to N-terminal pro-brain natriuretic peptide in stable coronary patients |
| title_full |
Parathormone levels add prognostic ability to N-terminal pro-brain natriuretic peptide in stable coronary patients |
| title_fullStr |
Parathormone levels add prognostic ability to N-terminal pro-brain natriuretic peptide in stable coronary patients |
| title_full_unstemmed |
Parathormone levels add prognostic ability to N-terminal pro-brain natriuretic peptide in stable coronary patients |
| title_sort |
Parathormone levels add prognostic ability to N-terminal pro-brain natriuretic peptide in stable coronary patients |
| dc.creator.none.fl_str_mv |
Gutiérrez-Landaluce, Carlos Aceña Navarro, Álvaro Pello, Ana Martínez-Milla, Juan González-Lorenzo, Óscar Tarín, Nieves Cristóbal, Carmen Blanco-Colio, Luis M. Martín Ventura, José Luis Huelmos, Ana López-Castillo, Marta Alonso, Joaquín López Bescós, Lorenzo Alonso-Pulpón Rivera, Luis Antonio González Parra, Emilio José Egido de los Ríos, Jesús Mahíllo-Fernández, Ignacio Lorenzo González, Óscar González-Casaus, María Luisa Tuñón Fernández, José Luis |
| author |
Gutiérrez-Landaluce, Carlos |
| author_facet |
Gutiérrez-Landaluce, Carlos Aceña Navarro, Álvaro Pello, Ana Martínez-Milla, Juan González-Lorenzo, Óscar Tarín, Nieves Cristóbal, Carmen Blanco-Colio, Luis M. Martín Ventura, José Luis Huelmos, Ana López-Castillo, Marta Alonso, Joaquín López Bescós, Lorenzo Alonso-Pulpón Rivera, Luis Antonio González Parra, Emilio José Egido de los Ríos, Jesús Mahíllo-Fernández, Ignacio Lorenzo González, Óscar González-Casaus, María Luisa Tuñón Fernández, José Luis |
| author_role |
author |
| author2 |
Aceña Navarro, Álvaro Pello, Ana Martínez-Milla, Juan González-Lorenzo, Óscar Tarín, Nieves Cristóbal, Carmen Blanco-Colio, Luis M. Martín Ventura, José Luis Huelmos, Ana López-Castillo, Marta Alonso, Joaquín López Bescós, Lorenzo Alonso-Pulpón Rivera, Luis Antonio González Parra, Emilio José Egido de los Ríos, Jesús Mahíllo-Fernández, Ignacio Lorenzo González, Óscar González-Casaus, María Luisa Tuñón Fernández, José Luis |
| author2_role |
author author author author author author author author author author author author author author author author author author author |
| dc.contributor.none.fl_str_mv |
Departamento de Medicina Facultad de Medicina |
| dc.subject.none.fl_str_mv |
Coronary artery disease Fibroblast growth factor-23 Mineral metabolism Parathormone Medicina |
| topic |
Coronary artery disease Fibroblast growth factor-23 Mineral metabolism Parathormone Medicina |
| description |
Aims: There are controversial data on the ability of the components of mineral metabolism (vitamin D, phosphate, parathormone [PTH], fibroblast growth factor-23 [FGF23], and klotho) to predict cardiovascular events. In addition, it is unknown whether they add any prognostic value to other well-known biomarkers. Methods and results: In 969 stable coronary patients, we determined plasma levels of all the aforementioned components of mineral metabolism with a complete set of clinical and biochemical variables, including N-terminal pro-brain natriuretic peptide (NT-proBNP), high-sensitivity troponin I (hs-TnI), and high-sensitivity C-reactive protein. Secondary outcomes were ischaemic events (any acute coronary syndrome, stroke, or transient ischaemic attack) and heart failure or death. The primary outcome was a composite of the secondary outcomes. Median follow-up was 5.39 years. Age was 60 (52–72) years. Median glomerular filtration rate was 80.4 (65.3–93.1) mL/min/1.73 m2. One-hundred and eighty-five patients developed the primary outcome. FGF23, PTH, hs-TnI, and NT-proBNP were directly related with the primary outcome on univariate Cox analysis, while Klotho and calcidiol were inversely related. On multivariate analysis, only PTH (HR 1.058 [CI 1.021–1.097]; P = 0.002) and NT-proBNP (HR 1.020 [CI 1.012–1.028]; P < 0.001) were independent predictors of the primary outcome but also for the secondary outcome of heart failure or death (HR 1.066 [CI 1.016–1.119]; P = 0.009 and HR 1.024 [CI 1.014–1.034]; P < 0.001, respectively). PTH was the only biomarker that predicted ischaemic events (HR 1.052 [1.010–1.096]; P = 0.016). Patients were divided in two subgroups according to FGF23 plasma levels. PTH retained its prognostic value only in patients with FGF23 levels above the median (>85.5 RU/mL) (P < 0.001) but not in patients with low FGF23 levels (P = 0.551). There was a significant interaction between FGF23 and PTH (P = 0.002). However, there was no significant interaction between PTH and both klotho and calcidiol levels. Conclusions: Parathormone is an independent predictor of cardiovascular events in coronary patients, adding complimentary prognostic information to NT-proBNP plasma levels. This predictive value is restricted to patients with high FGF23 plasma levels. This should be considered in the design of future studies in this field. |
| publishDate |
2021 |
| dc.date.none.fl_str_mv |
2021 2021-05-01 |
| dc.type.none.fl_str_mv |
research article http://purl.org/coar/resource_type/c_2df8fbb1 VoR http://purl.org/coar/version/c_970fb48d4fbd8a85 |
| dc.type.openaire.fl_str_mv |
info:eu-repo/semantics/article |
| format |
article |
| dc.identifier.none.fl_str_mv |
http://hdl.handle.net/10486/705140 https://dx.doi.org/10.1002/ehf2.13331 |
| url |
http://hdl.handle.net/10486/705140 https://dx.doi.org/10.1002/ehf2.13331 |
| dc.language.none.fl_str_mv |
Inglés eng |
| language_invalid_str_mv |
Inglés |
| language |
eng |
| dc.rights.none.fl_str_mv |
open access http://purl.org/coar/access_right/c_abf2 |
| dc.rights.openaire.fl_str_mv |
info:eu-repo/semantics/openAccess |
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open access http://purl.org/coar/access_right/c_abf2 |
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openAccess |
| dc.format.none.fl_str_mv |
application/pdf |
| dc.publisher.none.fl_str_mv |
The Heart Failure Association of the European Society of Cardiology |
| publisher.none.fl_str_mv |
The Heart Failure Association of the European Society of Cardiology |
| dc.source.none.fl_str_mv |
reponame:Biblos-e Archivo. Repositorio Institucional de la UAM instname:Universidad Autónoma de Madrid |
| instname_str |
Universidad Autónoma de Madrid |
| reponame_str |
Biblos-e Archivo. Repositorio Institucional de la UAM |
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Biblos-e Archivo. Repositorio Institucional de la UAM |
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|
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1869407744123994113 |
| spelling |
Parathormone levels add prognostic ability to N-terminal pro-brain natriuretic peptide in stable coronary patientsGutiérrez-Landaluce, CarlosAceña Navarro, ÁlvaroPello, AnaMartínez-Milla, JuanGonzález-Lorenzo, ÓscarTarín, NievesCristóbal, CarmenBlanco-Colio, Luis M.Martín Ventura, José LuisHuelmos, AnaLópez-Castillo, MartaAlonso, JoaquínLópez Bescós, LorenzoAlonso-Pulpón Rivera, Luis AntonioGonzález Parra, Emilio JoséEgido de los Ríos, JesúsMahíllo-Fernández, IgnacioLorenzo González, ÓscarGonzález-Casaus, María LuisaTuñón Fernández, José LuisCoronary artery diseaseFibroblast growth factor-23Mineral metabolismParathormoneMedicinaAims: There are controversial data on the ability of the components of mineral metabolism (vitamin D, phosphate, parathormone [PTH], fibroblast growth factor-23 [FGF23], and klotho) to predict cardiovascular events. In addition, it is unknown whether they add any prognostic value to other well-known biomarkers. Methods and results: In 969 stable coronary patients, we determined plasma levels of all the aforementioned components of mineral metabolism with a complete set of clinical and biochemical variables, including N-terminal pro-brain natriuretic peptide (NT-proBNP), high-sensitivity troponin I (hs-TnI), and high-sensitivity C-reactive protein. Secondary outcomes were ischaemic events (any acute coronary syndrome, stroke, or transient ischaemic attack) and heart failure or death. The primary outcome was a composite of the secondary outcomes. Median follow-up was 5.39 years. Age was 60 (52–72) years. Median glomerular filtration rate was 80.4 (65.3–93.1) mL/min/1.73 m2. One-hundred and eighty-five patients developed the primary outcome. FGF23, PTH, hs-TnI, and NT-proBNP were directly related with the primary outcome on univariate Cox analysis, while Klotho and calcidiol were inversely related. On multivariate analysis, only PTH (HR 1.058 [CI 1.021–1.097]; P = 0.002) and NT-proBNP (HR 1.020 [CI 1.012–1.028]; P < 0.001) were independent predictors of the primary outcome but also for the secondary outcome of heart failure or death (HR 1.066 [CI 1.016–1.119]; P = 0.009 and HR 1.024 [CI 1.014–1.034]; P < 0.001, respectively). PTH was the only biomarker that predicted ischaemic events (HR 1.052 [1.010–1.096]; P = 0.016). Patients were divided in two subgroups according to FGF23 plasma levels. PTH retained its prognostic value only in patients with FGF23 levels above the median (>85.5 RU/mL) (P < 0.001) but not in patients with low FGF23 levels (P = 0.551). There was a significant interaction between FGF23 and PTH (P = 0.002). However, there was no significant interaction between PTH and both klotho and calcidiol levels. Conclusions: Parathormone is an independent predictor of cardiovascular events in coronary patients, adding complimentary prognostic information to NT-proBNP plasma levels. This predictive value is restricted to patients with high FGF23 plasma levels. This should be considered in the design of future studies in this field.This work was supported by grants from Instituto de Salud Carlos III (ISCIII) and Fondos FEDER (Fondo Europeo de Desarrollo Regional) European Union (PI05/0451, PI14/1567, PI17/01615, and PI17/01495); Spanish Society of Cardiology; Spanish Society of Arteriosclerosis; RECAVA (Red Temática de Investigación Cooperativa en Enfermedades Cardiovasculares) (RD06/0014/0035); and Instituto de Salud Carlos III FEDER (FJD biobank: RD09/0076/00101). The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.The Heart Failure Association of the European Society of CardiologyDepartamento de MedicinaFacultad de Medicina20212021-05-01research articlehttp://purl.org/coar/resource_type/c_2df8fbb1VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10486/705140https://dx.doi.org/10.1002/ehf2.13331reponame:Biblos-e Archivo. Repositorio Institucional de la UAMinstname:Universidad Autónoma de MadridInglésengopen accesshttp://purl.org/coar/access_right/c_abf2info:eu-repo/semantics/openAccessoai:repositorio.uam.es:10486/7051402026-06-23T12:46:27Z |
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15,301603 |