- 著者
- Tadafumi Sugimoto Kaoru Dohi Katsuya Onishi Tomomi Yamada Masahide Horiguchi Takeshi Takamura Akihiro Kawamura Tetsuya Seko Mashio Nakamura Atsunobu Kasai Masaaki Ito
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- vol.78, no.11, pp.2704-2710, 2014-10-24 (Released:2014-10-24)
- 参考文献数
- 42
- 被引用文献数
- 3 6
Background:Secondary hyperparathyroidism develops as a compensatory response to chronic heart failure (HF) and renal failure. The role of parathyroid hormone (PTH) level in acute decompensated HF remains unclear. The aim of this study was therefore to investigate the relationships among mortality, renal function, and serum PTH level in acute decompensated HF patients.Methods and Results:A total of 266 consecutive patients admitted for acute decompensated HF without acute coronary syndrome (78±12 years; 48% male) were enrolled. Demographic, clinical, and laboratory characteristics were obtained on admission.During 1-year follow-up, 65 patients (24%) died. Serum PTH level on admission was within the normal range (10–65 pg/ml) in 108 patients (41%), of whom 39 (15%) had low-normal PTH (10–40 pg/ml). On Kaplan-Meier analysis all-cause mortality was significantly higher in patients with low-normal PTH than in those with high-normal (40–65 pg/ml) or high (>65 pg/ml) PTH (log-rank test). On univariate and multivariate Cox regression analysis, low-normal PTH was significantly associated with increased all-cause mortality (unadjusted HR, 2.88; 95% CI: 1.69–4.91; P<0.001; adjusted HR, 3.84; 95% CI: 1.54–9.57; P=0.004).Conclusions:In patients with acute decompensated HF resulting in hospitalization, low-normal PTH on admission is associated with increased all-cause mortality, regardless of renal function. (Circ J 2014; 78: 2704–2710)