Serum intact parathyroid hormone levels predict hospitalisation for heart failure

Sugimoto, Tadafumi; Tsuruo, Takashi; Onishi, Katsuya; Fujimoto, Naoki; Matsuda, Akimasa; Nakamori, Shiro; Matsuoka, Koji; Nakamura, Tomoaki; Koji, Takakazu; M, Ito

doi:10.1136/hrt.2008.147652

Cited by 69 publications

(60 citation statements)

References 32 publications

(28 reference statements)

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“…2,8 In epidemiological studies, PTH is increased in patients with HF 9 and has shown to be independently associated with hospitalization for HF in these patients. 10 Population studies have shown PTH elevation to be associated with major risk factors for HF, including hypertension, 11 left ventricular hypertrophy (LVH), 12 atrial fibrillation (AF), 13 myocardial dysfunction (N-terminal probrain natriuretic peptide [NT-proBNP]), be associated with cardiovascular disease (CVD), many have not 18,19 ; few prospective studies have specifically examined the association between PTH and incident HF in the general population. Two prospective studies in older adults have shown PTH levels to be related to incident HF 20,21 independent of known risk factors for HF, whereas 1 study conducted in middle-aged population showed the association to be present in obese subjects only.…”

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confidence: 99%

Elevated Parathyroid Hormone, But Not Vitamin D Deficiency, Is Associated With Increased Risk of Heart Failure in Older Men With and Without Cardiovascular Disease

Wannamethee

Welsh

Papacosta

et al. 2014

Circ: Heart Failure

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Background-Hyperparathyroidism and low vitamin D status have been implicated in the pathogenesis of heart failure (HF).We examined the prospective associations between parathyroid hormone (PTH), circulating 25-hydroxyvitamin D, and markers of mineral metabolism and risk of incident HF in older men with and without established cardiovascular disease. Methods and Results-Prospective study of 3731 men aged 60 to 79 years with no prevalent HF followed up for a mean period of 13 years, in whom there were 287 incident HF cases. Elevated PTH (≥55.6 pg/mL; top quarter) was associated with significantly higher risk of incident HF after adjustment for lifestyle characteristics, diabetes mellitus, blood lipids, blood pressure, lung function, heart rate, renal dysfunction, atrial fibrillation, forced expiratory volume in 1 second, and C-reactive protein (hazards ratio, 1.66; 95% confidence interval, 1.30-2.13). The increased risk was seen in both men with and without previous myocardial infarction or stroke (hazards ratio, 1.72; 95% confidence interval, 1.07-2.76; hazards ratio, 1.70; 95% confidence interval, 1.25-2.30, respectively). Elevated PTH was significantly associated with N-terminal probrain natriuretic peptide, a marker of left ventricular wall stress. By contrast, 25-hydroxyvitamin D and other markers of mineral metabolism including serum calcium and phosphate showed no significant association with incident HF after adjustment for age. Conclusions-Elevated PTH, but not 25-hydroxyvitamin D or other markers of mineral metabolism, is associated with increased risk of HF in both older men with and without myocardial infarction/stroke. This increased risk was not explained by its association with known risk factors for HF. Further studies are now needed to elucidate the mechanisms underlying this association. (Circ Heart Fail. 2014;7:732-739.)

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confidence: 99%

Elevated Parathyroid Hormone, But Not Vitamin D Deficiency, Is Associated With Increased Risk of Heart Failure in Older Men With and Without Cardiovascular Disease

Wannamethee

Welsh

Papacosta

et al. 2014

Circ: Heart Failure

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“…[1][2][3][4][5][6] Higher circulating PTH concentrations are associated with increased risk of fracture, hypertension, left ventricular hypertrophy, and in some studies with cardiovascular mortality. [7][8][9][10][11] PTH is regulated in response to circulating calcium concentrations by the calcium-sensing receptor, which is highly expressed in parathyroid tissue. [12][13][14] PTH concentration is further modulated by calcitriol, which interacts with DNA regulatory elements via the vitamin D nuclear receptor to suppress PTH, and is an established treatment for the secondary hyperparathyroidism seen in CKD.…”

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Genetic Variants Associated with Circulating Parathyroid Hormone

Robinson‐Cohen

Lutsey²,

Kleber

et al. 2016

JASN

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Parathyroid hormone (PTH) is a primary calcium regulatory hormone. Elevated serum PTH concentrations in primary and secondary hyperparathyroidism have been associated with bone disease, hypertension, and in some studies, cardiovascular mortality. Genetic causes of variation in circulating PTH concentrations are incompletely understood. We performed a genome-wide association study of serum PTH concentrations among 29,155 participants of European ancestry from 13 cohort studies (n=22,653 and n=6502 in discovery and replication analyses, respectively). We evaluated the association of single nucleotide polymorphisms (SNPs) with natural log-transformed PTH concentration adjusted for age, sex, season, study site, and principal components of ancestry. We discovered associations of SNPs from five independent regions with serum PTH concentration, including the strongest association with rs6127099 upstream of CYP24A1 (P=4.2 3 10 253 ), a gene that encodes the primary catabolic enzyme for 1,25-dihydroxyvitamin D and 25-dihydroxyvitamin D. Each additional copy of the minor allele at this SNP associated with 7% higher serum PTH concentration. The other SNPs associated with serum PTH concentration included rs4074995 within RGS14 (P=6.6 3 10 217 ), rs219779 adjacent to CLDN14 (P=3.5 3 10 216 ), rs4443100 near RTDR1 (P=8.7 3 10 29 ), and rs73186030 near CASR (P=4.8 3 10 28). Of these five SNPs, rs6127099, rs4074995, and rs219779 replicated. Thus, common genetic variants located near genes involved in vitamin D metabolism and calcium and renal phosphate transport associated with differences in circulating PTH concentrations. Future studies could identify the causal variants at these loci, and the clinical and functional relevance of these variants should be pursued.

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“…188 Such studies generated a concept of "salt-aldosterone product" in the aldosterone-mediated inflammation that impairs both kidney and cardiac function. Finally, recent work has shed light on the importance of cortisol in this aldosterone-salt axis in precipitating heart failure with preserved LV ejection fraction in a mouse model of pressure overload, 189 as well as the complex interaction of parathyroid hormone, potassium, and trace elements in mediating the inflammatory state in heart failure, 190,191 which was recently reviewed by Weber and outlined in Figure 6. 192 All of these factors, in combination with high salt levels, may contribute to this therapeutic resistant state of heart failure with preserved LV ejection fraction, which if addressed at an early stage may prevent heart failure, thereby making this more of the "internists' heart failure."…”

Section: Heart Failure With Preserved LV Ejection Fractionmentioning

confidence: 99%

Translational Success Stories: Angiotensin Receptor 1 Antagonists in Heart Failure

Dell’Italia

2011

Circulation Research

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Serum intact parathyroid hormone levels predict hospitalisation for heart failure

Abstract: Serum intact PTH levels obtained in outpatients with HF were shown to be an independent predictor of hospitalisation for HF.

Cited by 69 publications

References 32 publications

Elevated Parathyroid Hormone, But Not Vitamin D Deficiency, Is Associated With Increased Risk of Heart Failure in Older Men With and Without Cardiovascular Disease

Elevated Parathyroid Hormone, But Not Vitamin D Deficiency, Is Associated With Increased Risk of Heart Failure in Older Men With and Without Cardiovascular Disease

Genetic Variants Associated with Circulating Parathyroid Hormone

Translational Success Stories: Angiotensin Receptor 1 Antagonists in Heart Failure

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