Cortés Marcelino, Kallmeyer Andrea, Tarín Nieves, Cristóbal Carmen, Pello Ana María, Aceña Alvaro, Gutiérrez-Landaluce Carlos, Huelmos Ana, Alonso Joaquín, López-Bescós Lorenzo, Mahíllo-Fernández Ignacio, Lorenzo Óscar, González-Casaus María Luisa, Egido Jesús, Tuñón José
Department of Cardiology, Fundación Jiménez Díaz, Avenida Reyes Católicos 2, 28040, Madrid, Spain.
Faculty of Medicine and Biomedicine, Universidad Alfonso X el Sabio (UAX), 28691, Madrid, Spain.
Sci Rep. 2025 May 14;15(1):16744. doi: 10.1038/s41598-025-01334-2.
Alterations in plasma levels of the components of the mineral metabolism (MM) system are related to cardiovascular diseases. However, gender differences of the whole MM system in patients with acute coronary syndrome (ACS) have not been reported. Our objective was to analyse the potential differences on the prognostic role of MM in women suffering an ACS as compared to men. We included 1,230 patients with ACS and collected clinical data and plasma levels of MM components. Primary outcome was a composite of acute ischaemic events, heart failure and all-cause mortality. Secondary outcomes included each component separately. 282 patients (22.9%) were female. After 5.44 years of follow-up, primary outcome occurred in 28.0% women and 23.5% men, and death in 10.6% and 9.4% respectively. FGF23 was associated with primary outcome in both sexes, and calcidiol only in men (HR 1.04, CI95%1.00-1.03). Klotho levels are inversely related to all-cause mortality only in women (HR 0.80, CI95% 0.67-0.96), while calcidiol (HR 0.84, CI95%0.72-0.98) and FGF23 levels (HR 1.02 CI95%1.00-1.03) were predictors in men, highlighting a possible gender-specific prognostic biomarker. These results underline the importance of considering MM biomarkers in risk stratification and management of patients with acute coronary syndromes, with attention to gender differences.
矿物质代谢（MM）系统各成分的血浆水平改变与心血管疾病相关。然而，急性冠脉综合征（ACS）患者中整个MM系统的性别差异尚未见报道。我们的目的是分析MM在女性ACS患者与男性ACS患者中预后作用的潜在差异。我们纳入了1230例ACS患者，收集了临床数据以及MM系统各成分的血浆水平。主要结局是急性缺血事件、心力衰竭和全因死亡率的复合终点。次要结局包括各单一成分。282例患者（22.9%）为女性。经过5.44年的随访，主要结局在28.0%的女性和23.5%的男性中发生，死亡分别发生在10.6%的女性和9.4%的男性中。成纤维细胞生长因子23（FGF23）在两性中均与主要结局相关，而骨化二醇仅在男性中相关（风险比[HR]1.04，95%置信区间[CI]1.00 - 1.03）。仅在女性中，klotho水平与全因死亡率呈负相关（HR 0.80，95%CI 0.67 - 0.96），而在男性中，骨化二醇（HR 0.84，95%CI 0.72 - 0.98）和FGF23水平（HR 1.02，95%CI 1.00 - 1.03）是预测指标，突出了可能存在性别特异性的预后生物标志物。这些结果强调了在急性冠脉综合征患者的风险分层和管理中考虑MM生物标志物的重要性，并要关注性别差异。
