title: Correlations between serum intact parathyroid hormone (PTH) and N-terminal-probrain natriuretic peptide levels in elderly patients with chronic heart failure (CHF).
abstract: OBJECTIVE
  The aim of this study was to investigate the association between PTH and Nt-proBNP in elderly patients with CHF in an attempt to gain insights into the role of PTH in a community-based cohort of elderly patients with CHF.
  
  
  METHODS
  A total of 182 consecutive CHF patients with follow-up for mortality after 3 years were prospectively studied. Serum levels of intact PTH, Nt-proBNP and biochemical parameters were examined. The enrolled patients were divided into groups by the levels of PTH and New York Heart Association (NYHA) functional classes.
  
  
  RESULTS
  A total of 66 (36%) patients had PTH values above the upper limit of the normal range. Serum creatinine (p=0.001), estimated glomerular filtration rate (eGFR) (p=0.001), Nt-proBNP (p<0.001), serum calcium (p=0.030), heart rate (p=0.002) showed statistical significance in different stages of PTH. The mean PTH and Nt-proBNP levels increased as the NYHA functional class increased. The optimal cut-off value of PTH to predict CHF-related death was 48.98 pg/ml, with 57.14% sensitivity and 86.24% specificity. The best cut-off point of Nt-proBNP was 480 ng/ml with 76.47% sensitivity and 80.48% specificity. Over a mean follow-up of 3 years, Kaplan-Meier survival curves demonstrate that patients with higher levels of intact PTH had lower survival time, with a hazard ratio of 2.5 (95% CI 1.5-3.9).
  
  
  CONCLUSIONS
  The study has shown that serum intact PTH level obtained in the elderly patients with CHF is a novel biomarker associated with Nt-proBNP and could provide supplementary information for the diagnosis and prognostic prediction of CHF, especially when it is used in combination with Nt-proBNP.
authors.affiliation: Department of Geriatrics, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200092, PR China.
authors.forename: Shuang
authors.initials: S
authors.lastname: Zhang
authors.affiliation: Department of Geriatrics, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200092, PR China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Hu
authors.affiliation: Department of Geriatrics, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200092, PR China.
authors.forename: Lu
authors.initials: L
authors.lastname: Zhou
authors.affiliation: Department of Geriatrics, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200092, PR China.
authors.forename: Xiaojing
authors.initials: X
authors.lastname: Chen
authors.affiliation: Department of Geriatrics, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200092, PR China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Geriatrics, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200092, PR China.
authors.forename: Jiayu
authors.initials: J
authors.lastname: Wu
authors.affiliation: Department of Geriatrics, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200092, PR China.
authors.forename: Huimin
authors.initials: H
authors.lastname: He
authors.affiliation: Department of Geriatrics, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200092, PR China. Electronic address: yhgao2010@yahoo.com.
authors.forename: Yanhong
authors.initials: Y
authors.lastname: Gao
mesh_terms: D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002118:Calcium / Q000097:blood; D002681:China / Q000453:epidemiology; D003404:Creatinine / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006333:Heart Failure / Q000097:blood* / Q000401:mortality*; D006339:Heart Rate; D006801:Humans; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010281:Parathyroid Hormone / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*
chemical_list: D015415:Biomarkers; D010281:Parathyroid Hormone; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D003404:Creatinine; D002118:Calcium
keywords: Chronic heart failure; Elderly people; N-terminal-probrain natriuretic peptide; Parathyroid hormone