Sugimoto T, Tanigawa T, Onishi K, Fujimoto N, Matsuda A, Nakamori S, Matsuoka K, Nakamura T, Koji T, Ito M
Matsusaka Chuo General Hospital, Matsusaka, Japan.
Heart. 2009 Mar;95(5):395-8. doi: 10.1136/hrt.2008.147652. Epub 2008 Nov 10.
To assess whether circulating levels of intact parathyroid hormone (intact PTH) in outpatients predict hospitalisation for heart failure (HF).
Eighty-eight consecutive outpatients with HF were enrolled in the study. The independent association between intact PTH and hospitalisation for HF was assessed using Cox regression analysis.
Mean (SD) serum intact PTH levels significantly increased as New York Heart Association classes increased (I: 40 (21), II: 55 (24), III: 76 (46), IV: 131 (45) pg/ml). The receiver operating characteristic (ROC) curves showed intact PTH levels >or=47 pg/ml to be the optimal cut-off points for hospitalisation for HF, with sensitivity 87%, specificity 71% and area under the ROC curve 0.82 (95% CI 0.72 to 0.91). After adjustment for variables accepted to be predictors for hospitalisation due to HF (age, gender, hypertension, diabetes mellitus, atrial fibrillation, ischaemic heart disease, left ventricular ejection fraction, B-type natriuretic peptide, estimated glomerular filtration rate and cardiac drugs), intact PTH levels >or=47 pg/ml were associated with a hazard ratio of 7.13 for hospitalisation for HF (95% CI 1.79 to 28.4).
Serum intact PTH levels obtained in outpatients with HF were shown to be an independent predictor of hospitalisation for HF.
评估门诊患者中完整甲状旁腺激素(iPTH)的循环水平是否可预测心力衰竭(HF)住院情况。
连续纳入88例HF门诊患者。采用Cox回归分析评估iPTH与HF住院之间的独立关联。
随着纽约心脏协会心功能分级增加,血清iPTH平均(标准差)水平显著升高(I级:40(21),II级:55(24),III级:76(46),IV级:131(45)pg/ml)。受试者工作特征(ROC)曲线显示,iPTH水平≥47 pg/ml是HF住院的最佳截断点,敏感性为87%,特异性为71%,ROC曲线下面积为0.82(95%CI 0.72至0.91)。在对因HF住院公认的预测变量(年龄、性别、高血压、糖尿病、心房颤动、缺血性心脏病、左心室射血分数、B型利钠肽、估算肾小球滤过率和心脏药物)进行校正后,iPTH水平≥47 pg/ml与HF住院的风险比为7.13(95%CI 1.79至28.4)。
HF门诊患者的血清iPTH水平是HF住院的独立预测因素。