title: Serum parathyroid hormone and risk of adverse outcomes in patients with stable coronary heart disease.
abstract: OBJECTIVE
  Recent longitudinal studies have suggested an association of high serum parathyroid hormone levels (PTH) with elevated cardiovascular risk in the general population. This study presents analyses of the prognostic value of baseline PTH for subsequent cardiovascular events and all-cause mortality in a high-risk population with stable coronary heart disease.
  
  
  METHODS
  Based on measurements of PTH levels in 1133 patients recruited at two German rehabilitation clinics and followed over 8 years, multivariate Cox regression analysis was performed to estimate the risk of secondary cardiovascular events (including myocardial infarction, stroke and death due to cardiovascular diseases) and all-cause-mortality according to PTH quartiles (Q1-Q4) and continuous PTH concentrations.
  
  
  RESULTS
  During follow-up, 153 cardiovascular events and 124 deaths occurred. Age and sex-adjusted Cox regression analysis yielded statistically significant positive associations of PTH with both cardiovascular event incidence and all-cause mortality (HR (95% CI) per SD increase of PTH: 1.35 (1.21-1.51) and 1.25 (1.11-1.42), respectively). Associations remained essentially unchanged after additional adjustment for multiple cardiovascular risk factors. More detailed dose-response analyses showed strong risk elevation for above-normal levels of PTH (> 95th percentile), with essentially no association at lower levels.
  
  
  CONCLUSIONS
  The results of this first detailed study in a cohort of patients with stable coronary heart disease suggest an independent predictive value of above-normal PTH for the prognosis in patients with stable coronary heart disease.
authors.affiliation: Division of Clinical Epidemiology and Ageing Research C070, German Cancer Research Center, Heidelberg, Germany.
authors.forename: Norma Christine
authors.initials: NC
authors.lastname: Grandi
authors.forename: Lutz Philipp
authors.initials: LP
authors.lastname: Breitling
authors.forename: Harry
authors.initials: H
authors.lastname: Hahmann
authors.forename: Bernd
authors.initials: B
authors.lastname: Wüsten
authors.forename: Winfried
authors.initials: W
authors.lastname: März
authors.forename: Dietrich
authors.initials: D
authors.lastname: Rothenbacher
authors.forename: Hermann
authors.initials: H
authors.lastname: Brenner
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002423:Cause of Death / Q000639:trends; D003327:Coronary Disease / Q000097:blood* / Q000453:epidemiology / Q000534:rehabilitation; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood*; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D055815:Young Adult
chemical_list: D015415:Biomarkers; D010281:Parathyroid Hormone