[The effect of oral calcimimetics on cardiovascular events.]
The Evolve Trial showed no significant benefit of cinacalcet on the primary composite outcome(death or first non-fatal myocardial infarction, hospitalization for unstable angina, heart failure, or peripheral vascular event)but significantly reduced the incidence of heart failure in an intention-to-treat(ITT)analysis. In an adjusted ITT analysis and lag-censoring analysis, the effect of cinacalcet on the primary outcome was significant. The reduced incidence of cardiovascular events in the cinacalcet arm could by predicted by a >=30% reduction in FGF23 levels at week 20. In a post-hoc analysis stratified by age, cinacalcet reduced the primary outcome only in elderly patients(>=65 years). In Japanese MBD-5D cohort study, cinacalcet administration was associated with significantly lower mortality in patients with baseline iPTH >500 pg/mL and lower risk of death or hospitalization due to cardiovascular events in patients with iPTH >300 pg/mL, respectively.
Department of Comprehensive Kidney Disease Research, Osaka University Graduate School of Medicine, Japan.
Takayuki
T
Hamano
D000284:Administration, Oral; D057966:Calcimimetic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002118:Calcium / Q000097:blood; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors / Q000097:blood; D006801:Humans; D011188:Potassium / Q000097:blood
D057966:Calcimimetic Agents; C000717427:FGF23 protein, human; D005346:Fibroblast Growth Factors; D000089703:Fibroblast Growth Factor-23; D011188:Potassium; D002118:Calcium