title: Parameters of mineral metabolism predict midterm clinical outcome in end-stage heart failure patients.
abstract: OBJECTIVE
  We investigated to which extent disturbances in mineral metabolism predict 90-day clinical outcome in end-stage heart failure patients.
  
  
  METHODS
  Among numerous biochemical parameters, we measured serum levels of sodium and magnesium, the calciotropic hormones parathyroid hormone and 1,25-dihydroxyvitamin D as well as fibroblast growth factor-23 (a phosphaturic hormone) in 305 cardiac transplant candidates. Primary endpoint was a composite of the need of mechanical circulatory support (MCS), transplantation, or death.
  
  
  RESULTS
  Of the study cohort, 33.4% reached the primary endpoint. In detail, 19% were transplanted (the vast majority was listed "high urgent"), 8.8% died and 5.6% received MCS implants. As determined by logistic regression analysis, all aforementioned biochemical parameters were independently related to the primary endpoint. Results did not change substantially when transplanted patients were censored. A risk score (0-5 points) was developed. Of the patients who scored 5 points 89.5% reached the primary endpoint whereas of the patients with a zero score only 3.8% reached the primary endpoint.
  
  
  CONCLUSIONS
  Our data demonstrate that in addition to the well-known predictive value of disturbed sodium metabolism, derangements in calcium, phosphate, and magnesium metabolism also predict midterm clinical outcome in end-stage heart failure patients.
authors: Clinic for Thoracic and Cardiovascular Surgery, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Georgstrasse 11, Bad Oeynhausen, Germany. azittermann@hdz-nrw.de
authors: Armin
authors: A
authors: Zittermann
authors: Uwe
authors: U
authors: Fuchs
authors: Joachim
authors: J
authors: Kuhn
authors: Jens
authors: J
authors: Dreier
authors: Uwe
authors: U
authors: Schulz
authors: Jan F
authors: JF
authors: Gummert
authors: Jochen
authors: J
authors: Börgermann
mesh_terms: D015415:Biomarkers / Q000097:blood; D018572:Disease-Free Survival; D005260:Female; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors / Q000097:blood; D005858:Germany; D006333:Heart Failure / Q000097:blood* / Q000401:mortality / Q000628:therapy; D016027:Heart Transplantation; D006353:Heart-Assist Devices; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008274:Magnesium / Q000097:blood; D008297:Male; D008659:Metabolic Diseases / Q000097:blood* / Q000401:mortality / Q000628:therapy; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D010865:Pilot Projects; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors; D012964:Sodium / Q000097:blood; D013997:Time Factors; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood
chemical_list: D015415:Biomarkers; C470125:PTH protein, human; D010281:Parathyroid Hormone; D014807:Vitamin D; D005346:Fibroblast Growth Factors; C097949:1,25-dihydroxyvitamin D; D000089703:Fibroblast Growth Factor-23; D012964:Sodium; D008274:Magnesium