title: Phosphorus is associated with coronary artery disease in patients with preserved renal function.
abstract: High serum phosphorus levels have been associated with mortality and cardiovascular events in patients with chronic kidney disease and in the general population. In addition, high phosphorus levels have been shown to induce vascular calcification and endothelial dysfunction in vitro. The aim of this study was to evaluate the relation of phosphorus and coronary calcification and atherosclerosis in the setting of normal renal function. This was a cross-sectional study involving 290 patients with suspected coronary artery disease and undergoing elective coronary angiography, with a creatinine clearance >60 ml/min/1.73 m(2). Coronary artery obstruction was assessed by the Friesinger score and coronary artery calcification by multislice computed tomography. Serum phosphorus was higher in patients with an Agatston score >10 than in those with an Agatston score ≤ 10 (3.63 ± 0.55 versus 3.49 ± 0.52 mg/dl; p = 0.02). In the patients with Friesinger scores >4, serum phosphorus was higher (3.6 ± 0.5 versus 3.5 ± 0.6 mg/dl, p = 0.04) and median intact fibroblast growth factor 23 was lower (40.3 pg/ml versus 45.7 pg/ml, p = 0.01). Each 0.1-mg/dl higher serum phosphate was associated with a 7.4% higher odds of having a Friesinger score >4 (p = 0.03) and a 6.1% greater risk of having an Agatston score >10 (p = 0.01). Fibroblast growth factor 23 was a negative predictor of Friesinger score (p = 0.002). In conclusion, phosphorus is positively associated with coronary artery calcification and obstruction in patients with suspected coronary artery disease and preserved renal function.
authors.affiliation: Nephrology Department, University of São Paulo School of Medicine, São Paulo, Brazil. analudicancela@yahoo.com.br
authors.forename: Ana Ludimila
authors.initials: AL
authors.lastname: Cancela
authors.forename: Raul Dias
authors.initials: RD
authors.lastname: Santos
authors.forename: Silvia Maria
authors.initials: SM
authors.lastname: Titan
authors.forename: Patrícia Taschner
authors.initials: PT
authors.lastname: Goldenstein
authors.forename: Carlos Eduardo
authors.initials: CE
authors.lastname: Rochitte
authors.forename: Pedro Alves
authors.initials: PA
authors.lastname: Lemos
authors.forename: Luciene Machado
authors.initials: LM
authors.lastname: dos Reis
authors.forename: Fabiana Giorgetti
authors.initials: FG
authors.lastname: Graciolli
authors.forename: Vanda
authors.initials: V
authors.lastname: Jorgetti
authors.forename: Rosa Maria
authors.initials: RM
authors.lastname: Moysés
mesh_terms: D000368:Aged; D002114:Calcinosis / Q000097:blood* / Q000401:mortality / Q000473:pathology / Q000503:physiopathology; D003324:Coronary Artery Disease / Q000097:blood* / Q000401:mortality / Q000473:pathology / Q000503:physiopathology; D023921:Coronary Stenosis / Q000097:blood* / Q000401:mortality / Q000473:pathology / Q000503:physiopathology; D003331:Coronary Vessels / Q000378:metabolism* / Q000473:pathology / Q000503:physiopathology; D005260:Female; D006801:Humans; D007668:Kidney / Q000378:metabolism* / Q000473:pathology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010758:Phosphorus / Q000097:blood*
chemical_list: D010758:Phosphorus