Division of Endocrinology and Nuclear Medicine, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria.
Eur Heart J. 2010 Jul;31(13):1591-8. doi: 10.1093/eurheartj/ehq109. Epub 2010 May 2.
Elevated parathyroid hormone (PTH) levels have been associated with increased cardiovascular risk in the general population. We aimed to elucidate whether PTH levels are associated with mortality and fatal cardiovascular events in patients referred for coronary angiography.
Intact PTH was measured in 3232 Caucasian patients from the LUdwigshafen RIsk and Cardiovascular Health (LURIC) study, who underwent coronary angiography at baseline (1997-2000). During a median follow-up time of 7.7 years, 742 patients died including 467 deaths due to cardiovascular causes. Unadjusted Cox proportional hazard ratios (HRs) (with 95% confidence intervals) in the fourth when compared to the first PTH quartile were 2.13 (1.75-2.60) for all-cause and 2.47 (1.92-3.17) for cardiovascular mortality. After adjustments for common cardiovascular risk factors, these HRs remained significant with 1.71 (1.39-2.10) for all-cause and 2.02 (1.55-2.63) for cardiovascular mortality. Among specific cardiovascular events we observed a particularly strong association of PTH with sudden cardiac death (SCD). The adjusted HR for SCD in the first vs. the fourth PTH quartile was 2.68 (1.71-4.22).
Our results among patients undergoing coronary angiography show that PTH levels are an independent risk factor for mortality and cardiovascular events warranting further studies to evaluate whether PTH modifying treatments reduce cardiovascular risk.
甲状旁腺激素（PTH）水平升高与普通人群心血管风险增加相关。我们旨在阐明甲状旁腺激素水平与接受冠状动脉造影检查的患者的死亡率和致命心血管事件是否相关。
在基线（1997-2000 年）进行冠状动脉造影的 3232 名白种人 LURIC 研究患者中测量了完整的 PTH。在中位数为 7.7 年的随访期间，742 名患者死亡，其中 467 名死于心血管原因。与第 1 四分位 PTH 相比，第 4 四分位 PTH 的未经调整的 Cox 比例风险比（HR）（95%置信区间）分别为全因死亡 2.13（1.75-2.60）和心血管死亡 2.47（1.92-3.17）。在调整常见心血管危险因素后，这些 HR 仍然显著，全因死亡的 HR 为 1.71（1.39-2.10），心血管死亡的 HR 为 2.02（1.55-2.63）。在特定的心血管事件中，我们观察到 PTH 与心源性猝死（SCD）之间存在特别强的关联。第 1 四分位与第 4 四分位 PTH 相比 SCD 的调整 HR 为 2.68（1.71-4.22）。
我们在接受冠状动脉造影的患者中的研究结果表明，PTH 水平是死亡率和心血管事件的独立危险因素，需要进一步研究评估 PTH 调节治疗是否降低心血管风险。
