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- Title
Circulating fibroblast growth factor-23 plasma levels predict adverse cardiovascular outcomes in patients with diabetes mellitus with coronary artery disease.
- Authors
Tuñón, José; Fernández‐Fernández, Beatriz; Carda, Rocío; Pello, Ana M.; Cristóbal, Carmen; Tarín, Nieves; Aceña, Álvaro; González‐Casaus, María Luisa; Huelmos, Ana; Alonso, Joaquín; Lorenzo, Óscar; González‐Parra, Emilio; Hernández‐González, Ignacio; Mahíllo‐Fernández, Ignacio; López‐Bescós, Lorenzo; Egido, Jesús
- Abstract
<bold>Background: </bold>Abnormalities of fibroblast growth factor-23 (FGF-23) plasma levels predict adverse outcomes in patients with coronary artery disease. However, FGF-23 has a different behaviour in the presence of type 2 diabetes mellitus (T2D). We explored whether the presence of T2D affects the predictive power of FGF-23.<bold>Methods: </bold>In 704 patients with stable coronary artery disease, FGF-23, calcidiol, parathormone (PTH) and phosphate plasma levels were prospectively assessed. The primary outcome was the development of acute ischemic events (acute coronary syndrome, stroke or transient ischemic attack), heart failure or death.<bold>Results: </bold>One hundred seventy-three (24.6%) patients had T2D, without differences in age, sex or estimated glomerular filtration rate as compared with non-diabetic patients. Serum PTH was lower and phosphate higher in T2D than in non-diabetic patients, without differences in FGF-23 or calcidiol levels. During follow-up (2.15 ± 0.99 years), 26 (15.2%) T2D and 51 (9.6%) non-diabetic patients developed the outcome (p = 0.048). T2D patients who developed the outcome had higher FGF-23 [112.0 (59.9, 167.6) vs 68.9 (54.2, 93.0) RU/mL; p = 0.002], PTH [71.3 (47.3, 106.6) vs 51.9 (40.8, 66.2) pg/mL; p = 0.004) and phosphate (3.53 ± 0.71 vs 3.25 ± 0.50 mg/dL; p = 0.017) levels than T2D subjects who remained stable. These differences were not significant in non-diabetic patients. By multivariable Cox proportional hazard model, FGF-23 predicted independently the outcome in T2D patients [hazard ratio = 1.277; 95% CI (1.132, 1.442)] but not in those without T2D.<bold>Conclusions: </bold>FGF-23 plasma levels predict adverse cardiovascular outcomes in coronary artery disease patients who have T2D but not in those without T2D. This finding should be confirmed in larger studies. Copyright © 2016 John Wiley & Sons, Ltd.
- Subjects
GLOMERULAR filtration rate; RESEARCH; RESEARCH methodology; CARDIOVASCULAR diseases; PROGNOSIS; CASE-control method; EVALUATION research; MEDICAL cooperation; TYPE 2 diabetes; VITAMIN D; PARATHYROID hormone; COMPARATIVE studies; CORONARY artery disease; PHOSPHATES; LONGITUDINAL method; DISEASE complications
- Publication
Diabetes/Metabolism Research & Reviews, 2016, Vol 32, Issue 7, p685
- ISSN
1520-7552
- Publication type
journal article
- DOI
10.1002/dmrr.2787