Propensity for Calcification in Serum Associates With 2-Year Cardiovascular Mortality in Ischemic Heart Failure With Reduced Ejection Fraction

Frontiers in Medicine

article

Marija Bojic¹  Lorenz Koller²  Daniel Cejka³  Alexander Niessner²  Bernhard Bielesz¹ 

[1] Division of Nephrology and Dialysis, Department of Medicine III, Medical University of Vienna;Division of Cardiology, Department of Medicine II, Medical University of Vienna;Department of Medicine III, Transplantation Medicine

关键词: calcification propensity;    heart failure with reduced ejection fraction (HFrEF);    kidney failure;    chronic kidney disease;    cardiovascular;    mortality;    vascular calcifcation;    T 50 test;   

DOI  :  10.3389/fmed.2021.672348

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Background: The propensity of serum to calcify, as assessed by the T 50 -test, associates with mortality in patients with chronic kidney disease. In chronic heart failure, phosphate and fibroblast growth factor-23 (FGF-23), which are important components of the vascular calcification pathway, have been linked to patient survival. Here, we investigated whether T 50 associates with overall and cardiovascular survival in patients with chronic heart failure with reduced ejection fraction (HFrEF). Methods: We measured T 50 , intact and c-terminal FGF-23 levels in a cohort of 306 HFrEF patients. Associations with overall and cardiovascular mortality were analyzed in survival analysis and Cox-regression models. Results: After a median follow-up time of 3.2 years (25th−75th percentile: 2.0–4.9 years), 114 patients (37.3%) died due to any cause and 76 patients (24.8%) died due to cardiovascular causes. 139 patients (45.4%) had ischemic and 167 patients (54.6%) had non-ischemic HFrEF. Patients with ischemic HFrEF in the lowest T 50 -tertile had significantly greater 2-year cardiovascular mortality compared to patients in higher tertiles ( p = 0.011). In ischemic but not in non-ischemic HFrEF, T 50 was significantly associated with cardiovascular mortality in univariate ( p = 0.041) and fully adjusted ( p = 0.046) Cox regression analysis. Significant associations of intact and c-terminal FGF-23 with all-cause and cardiovascular mortality in univariate Cox regression analysis did not remain significant after adjustment for confounding factors. Conclusion: T 50 is associated with 2-year cardiovascular mortality in patients with ischemic HFrEF but not in non-ischemic HFrEF. More research on the role of T 50 measurements in coronary artery disease is warranted.

【 授权许可】

CC BY