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Coexistence of Low Vitamin D and High Fibroblast Growth Factor-23 Plasma Levels Predicts an Adverse Outcome in Patients with Coronary Artery Disease
OBJECTIVE: Vitamin D and fibroblast growth factor-23 (FGF-23) are related with cardiovascular disorders. We have investigated the relationship of calcidiol (vitamin D metabolite) and FGF-23 plasma levels with the incidence of adverse outcomes in patients with coronary artery disease. METHODS: Prospe...
Autores principales: | , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3991663/ https://www.ncbi.nlm.nih.gov/pubmed/24748388 http://dx.doi.org/10.1371/journal.pone.0095402 |
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author | Tuñón, José Cristóbal, Carmen Tarín, Nieves Aceña, Álvaro González-Casaus, María Luisa Huelmos, Ana Alonso, Joaquín Lorenzo, Óscar González-Parra, Emilio Mahíllo-Fernández, Ignacio Pello, Ana María Carda, Rocío Farré, Jerónimo Rodríguez-Artalejo, Fernando López-Bescós, Lorenzo Egido, Jesús |
author_facet | Tuñón, José Cristóbal, Carmen Tarín, Nieves Aceña, Álvaro González-Casaus, María Luisa Huelmos, Ana Alonso, Joaquín Lorenzo, Óscar González-Parra, Emilio Mahíllo-Fernández, Ignacio Pello, Ana María Carda, Rocío Farré, Jerónimo Rodríguez-Artalejo, Fernando López-Bescós, Lorenzo Egido, Jesús |
author_sort | Tuñón, José |
collection | PubMed |
description | OBJECTIVE: Vitamin D and fibroblast growth factor-23 (FGF-23) are related with cardiovascular disorders. We have investigated the relationship of calcidiol (vitamin D metabolite) and FGF-23 plasma levels with the incidence of adverse outcomes in patients with coronary artery disease. METHODS: Prospective follow-up study of 704 outpatients, attending the departments of Cardiology of four hospitals in Spain, 6–12 months after an acute coronary event. Baseline calcidiol, FGF-23, parathormone, and phosphate plasma levels were assessed. The outcome was the development of acute ischemic events (any acute coronary syndrome, stroke, or transient ischemic attack), heart failure, or death. Cox regression adjusted for the main confounders was performed. RESULTS: Calcidiol levels showed a moderate-severe decrease in 57.3% of cases. Parathormone, FGF-23, and phosphate levels were increased in 30.0%, 11.5% and 0.9% of patients, respectively. Only 22.4% of patients had glomerular filtration rate<60 ml/min1.73 m(2). After a mean follow-up was 2.15±0.99 years, 77 patients developed the outcome. Calcidiol (hazard ratio [HR] = 0.67; 95% confidence interval [CI] = 0.48–0.94; p = 0.021) and FGF-23 (HR = 1.13; 95% CI = 1.04–1.23; p = 0.005) plasma levels predicted independently the outcome. There was a significant interaction between calcidiol and FGF-23 levels (p = 0.025). When the population was divided according to FGF-23 levels, calcidiol still predicted the outcome independently in patients with FGF-23 levels higher than the median (HR = 0.50; 95% CI = 0.31–0.80; p = 0.003) but not in those with FGF-23 levels below this value (HR = 1.03; 95% CI = 0.62–1.71; p = 0.904). CONCLUSIONS: Abnormalities in mineral metabolism are frequent in patients with stable coronary artery disease. In this population, low calcidiol plasma levels predict an adverse prognosis in the presence of high FGF-23 levels. |
format | Online Article Text |
id | pubmed-3991663 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-39916632014-04-21 Coexistence of Low Vitamin D and High Fibroblast Growth Factor-23 Plasma Levels Predicts an Adverse Outcome in Patients with Coronary Artery Disease Tuñón, José Cristóbal, Carmen Tarín, Nieves Aceña, Álvaro González-Casaus, María Luisa Huelmos, Ana Alonso, Joaquín Lorenzo, Óscar González-Parra, Emilio Mahíllo-Fernández, Ignacio Pello, Ana María Carda, Rocío Farré, Jerónimo Rodríguez-Artalejo, Fernando López-Bescós, Lorenzo Egido, Jesús PLoS One Research Article OBJECTIVE: Vitamin D and fibroblast growth factor-23 (FGF-23) are related with cardiovascular disorders. We have investigated the relationship of calcidiol (vitamin D metabolite) and FGF-23 plasma levels with the incidence of adverse outcomes in patients with coronary artery disease. METHODS: Prospective follow-up study of 704 outpatients, attending the departments of Cardiology of four hospitals in Spain, 6–12 months after an acute coronary event. Baseline calcidiol, FGF-23, parathormone, and phosphate plasma levels were assessed. The outcome was the development of acute ischemic events (any acute coronary syndrome, stroke, or transient ischemic attack), heart failure, or death. Cox regression adjusted for the main confounders was performed. RESULTS: Calcidiol levels showed a moderate-severe decrease in 57.3% of cases. Parathormone, FGF-23, and phosphate levels were increased in 30.0%, 11.5% and 0.9% of patients, respectively. Only 22.4% of patients had glomerular filtration rate<60 ml/min1.73 m(2). After a mean follow-up was 2.15±0.99 years, 77 patients developed the outcome. Calcidiol (hazard ratio [HR] = 0.67; 95% confidence interval [CI] = 0.48–0.94; p = 0.021) and FGF-23 (HR = 1.13; 95% CI = 1.04–1.23; p = 0.005) plasma levels predicted independently the outcome. There was a significant interaction between calcidiol and FGF-23 levels (p = 0.025). When the population was divided according to FGF-23 levels, calcidiol still predicted the outcome independently in patients with FGF-23 levels higher than the median (HR = 0.50; 95% CI = 0.31–0.80; p = 0.003) but not in those with FGF-23 levels below this value (HR = 1.03; 95% CI = 0.62–1.71; p = 0.904). CONCLUSIONS: Abnormalities in mineral metabolism are frequent in patients with stable coronary artery disease. In this population, low calcidiol plasma levels predict an adverse prognosis in the presence of high FGF-23 levels. Public Library of Science 2014-04-18 /pmc/articles/PMC3991663/ /pubmed/24748388 http://dx.doi.org/10.1371/journal.pone.0095402 Text en © 2014 Tuñón et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited. |
spellingShingle | Research Article Tuñón, José Cristóbal, Carmen Tarín, Nieves Aceña, Álvaro González-Casaus, María Luisa Huelmos, Ana Alonso, Joaquín Lorenzo, Óscar González-Parra, Emilio Mahíllo-Fernández, Ignacio Pello, Ana María Carda, Rocío Farré, Jerónimo Rodríguez-Artalejo, Fernando López-Bescós, Lorenzo Egido, Jesús Coexistence of Low Vitamin D and High Fibroblast Growth Factor-23 Plasma Levels Predicts an Adverse Outcome in Patients with Coronary Artery Disease |
title | Coexistence of Low Vitamin D and High Fibroblast Growth Factor-23 Plasma Levels Predicts an Adverse Outcome in Patients with Coronary Artery Disease |
title_full | Coexistence of Low Vitamin D and High Fibroblast Growth Factor-23 Plasma Levels Predicts an Adverse Outcome in Patients with Coronary Artery Disease |
title_fullStr | Coexistence of Low Vitamin D and High Fibroblast Growth Factor-23 Plasma Levels Predicts an Adverse Outcome in Patients with Coronary Artery Disease |
title_full_unstemmed | Coexistence of Low Vitamin D and High Fibroblast Growth Factor-23 Plasma Levels Predicts an Adverse Outcome in Patients with Coronary Artery Disease |
title_short | Coexistence of Low Vitamin D and High Fibroblast Growth Factor-23 Plasma Levels Predicts an Adverse Outcome in Patients with Coronary Artery Disease |
title_sort | coexistence of low vitamin d and high fibroblast growth factor-23 plasma levels predicts an adverse outcome in patients with coronary artery disease |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3991663/ https://www.ncbi.nlm.nih.gov/pubmed/24748388 http://dx.doi.org/10.1371/journal.pone.0095402 |
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