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Parathyroid hormone and vitamin D—markers for cardiovascular and all cause mortality in heart failure
Author(s) -
Schierbeck Louise Lind,
Jensen Torben Slott,
Bang Ulrich,
Jensen Gorm,
Køber Lars,
Jensen JensErik Beck
Publication year - 2011
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1093/eurjhf/hfr016
Subject(s) - medicine , vitamin d and neurology , parathyroid hormone , hazard ratio , heart failure , ejection fraction , vitamin d deficiency , prospective cohort study , endocrinology , secondary hyperparathyroidism , population , hyperparathyroidism , natriuretic peptide , cardiology , proportional hazards model , renal function , confidence interval , calcium , environmental health
Aims To investigate levels of vitamin D and parathyroid hormone (PTH) in a population of heart failure (HF) patients, and to evaluate whether vitamin D and PTH are related to prognosis. Methods and results This was a prospective study of 148 HF outpatients (mean age 68 years, 102 men) with follow‐up for mortality after 3½ years. Levels of N‐terminal pro‐brain natriuretic peptide (NT‐proBNP), PTH, 25‐hydroxyvitamin D (25‐OHD), and several other biomarkers were examined. Mortality and cardiovascular mortality were analysed in multivariable regression analyses adjusting for other independent prognostic variables. Vitamin D deficiency (≤50 nmol/L) was prevalent in 43% of the population; 26% had elevated PTH levels; none had primary hyperparathyroidism. We found a strong and independent significant association of both PTH and vitamin D to mortality, which was independent of other clinically important parameters [NT‐proBNP, estimated glomerular filtration rate (eGFR), age, and left ventricular ejection fraction (LVEF)]. Both PTH and vitamin D were also significantly associated with all cause mortality. In an adjusted model, we found a hazard ratio of 1.9 (confidence interval 1.1–3.4) for vitamin D deficiency and 2.0 (1.0–3.8) for the upper median of PTH, respectively. Conclusion In this relatively small prospective study, PTH and vitamin D were independently associated with all cause and cardiovascular mortality in patients with HF. This was independent of other known risk factors such as eGFR, LVEF, NT‐proBNP, and age.