title: Prognostic value of serum parathyroid hormone level in acute decompensated heart failure.
abstract: BACKGROUND
  Secondary hyperparathyroidism develops as a compensatory response to chronic heart failure (HF) and renal failure. The role of parathyroid hormone (PTH) level in acute decompensated HF remains unclear. The aim of this study was therefore to investigate the relationships among mortality, renal function, and serum PTH level in acute decompensated HF patients. METHODS AND RESULTS: A total of 266 consecutive patients admitted for acute decompensated HF without acute coronary syndrome (78±12 years; 48% male) were enrolled. Demographic, clinical, and laboratory characteristics were obtained on admission.During 1-year follow-up, 65 patients (24%) died. Serum PTH level on admission was within the normal range (10-65 pg/ml) in 108 patients (41%), of whom 39 (15%) had low-normal PTH (10-40 pg/ml). On Kaplan-Meier analysis all-cause mortality was significantly higher in patients with low-normal PTH than in those with high-normal (40-65 pg/ml) or high (>65 pg/ml) PTH (log-rank test). On univariate and multivariate Cox regression analysis, low-normal PTH was significantly associated with increased all-cause mortality (unadjusted HR, 2.88; 95% CI: 1.69-4.91; P<0.001; adjusted HR, 3.84; 95% CI: 1.54-9.57; P=0.004).
  
  
  CONCLUSIONS
  In patients with acute decompensated HF resulting in hospitalization, low-normal PTH on admission is associated with increased all-cause mortality, regardless of renal function.
authors.affiliation: Department of Cardiology, Ise Red Cross Hospital.
authors.forename: Tadafumi
authors.initials: T
authors.lastname: Sugimoto
authors.forename: Kaoru
authors.initials: K
authors.lastname: Dohi
authors.forename: Katsuya
authors.initials: K
authors.lastname: Onishi
authors.forename: Tomomi
authors.initials: T
authors.lastname: Yamada
authors.forename: Masahide
authors.initials: M
authors.lastname: Horiguchi
authors.forename: Takeshi
authors.initials: T
authors.lastname: Takamura
authors.forename: Akihiro
authors.initials: A
authors.lastname: Kawamura
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Seko
authors.forename: Mashio
authors.initials: M
authors.lastname: Nakamura
authors.forename: Atsunobu
authors.initials: A
authors.lastname: Kasai
authors.forename: Masaaki
authors.initials: M
authors.lastname: Ito
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000097:blood* / Q000401:mortality* / Q000628:therapy; D006801:Humans; D008297:Male; D010281:Parathyroid Hormone / Q000097:blood*; D015996:Survival Rate
chemical_list: D010281:Parathyroid Hormone