Association of Fibroblast Growth Factor-23 Levels and Angiotensin-Converting Enzyme Inhibition in Chronic Systolic Heart Failure
Jazyk angličtina Země Spojené státy americké Médium print
Typ dokumentu časopisecké články, pozorovací studie, práce podpořená grantem
PubMed
26450001
DOI
10.1016/j.jchf.2015.05.012
PII: S2213-1779(15)00425-4
Knihovny.cz E-zdroje
- Klíčová slova
- adverse events, angiotensin-converting enzyme inhibitor, fibroblast growth factor-23, heart failure, outcome,
- MeSH
- absorpční fotometrie metody MeSH
- analýza přežití MeSH
- biologické markery MeSH
- chronická nemoc MeSH
- chronické selhání ledvin etiologie mortalita patofyziologie MeSH
- dopplerovská echokardiografie MeSH
- fibroblastové růstové faktory krev MeSH
- fibroblastový růstový faktor 23 MeSH
- hodnocení rizik MeSH
- inhibitory ACE terapeutické užití MeSH
- Kaplanův-Meierův odhad MeSH
- kohortové studie MeSH
- lidé středního věku MeSH
- lidé MeSH
- multivariační analýza MeSH
- prediktivní hodnota testů MeSH
- prognóza MeSH
- retrospektivní studie MeSH
- senioři MeSH
- stupeň závažnosti nemoci MeSH
- systolické srdeční selhání krev komplikace farmakoterapie mortalita MeSH
- vyšetření funkce ledvin MeSH
- výsledek terapie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- pozorovací studie MeSH
- práce podpořená grantem MeSH
- Názvy látek
- biologické markery MeSH
- FGF23 protein, human MeSH Prohlížeč
- fibroblastové růstové faktory MeSH
- fibroblastový růstový faktor 23 MeSH
- inhibitory ACE MeSH
OBJECTIVES: The aim of this study was to evaluate the association of fibroblast growth factor (FGF)-23 with clinical and laboratory findings, the prognostic value of FGF-23, and the relationship between angiotensin-converting enzyme inhibitor (ACEi) therapy, FGF-23 levels, and outcomes in patients with chronic systolic heart failure (HF). BACKGROUND: FGF-23 is a bone-derived hormone regulating mineral metabolism. Higher FGF-23 levels are associated with an increased risk of cardiovascular mortality or HF development. Mechanisms leading to increased FGF-23 and its prognostic value have not been thoroughly studied in HF. METHODS: FGF-23 was measured in 369 patients (mean age 59 ± 11 years, 84% male) with systolic HF. Patients were followed for adverse events (e.g., death, urgent heart transplantation, ventricular assist device implantation). RESULTS: Tricuspid regurgitation severity, chronic kidney disease (CKD), alkaline phosphatase concentrations, inferior vena cava dilation, and absence of ACEi therapy were independently associated with FGF-23. FGF-23 was independently associated with outcomes in patients without CKD (hazard ratio [HR]: 1.43, 95% confidence interval [CI]: 1.14 to 1.78), but not in CKD patients (HR: 1.12, 95% CI: 0.87 to 1.45). In patients without CKD and with FGF-23 in the highest tertile, ACEi therapy was associated with a lower risk of adverse events (HR: 0.42, 95% CI: 0.21 to 0.81), whereas no association was seen in the remaining patients (HR: 1.18, 95% CI: 0.52 to 2.70). CONCLUSIONS: In systolic HF, elevated FGF-23 is an independent predictor of adverse events, particularly in patients with preserved renal function. The association of FGF-23 with adverse events likely reflects early alterations of renal hemodynamics and renin-angiotensin system activation. Increased FGF-23 may identify a subset of HF patients benefiting from ACEi therapy.
Department of Cardiology Institute for Clinical and Experimental Medicine Prague Czech Republic
Department of Pathology Brigham and Women's Hospital Harvard Medical School Boston Massachusetts
Citace poskytuje Crossref.org
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