scholarly journals Higher levels of serum phosphorus are associated with coronary calcification post heart transplantation

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
I Ozcan ◽  
T Toya ◽  
M T Corban ◽  
A Ahmad ◽  
V Nardi ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Heart Transplantation ◽  
Coronary Calcification ◽  
Serum Phosphorus ◽  
Normal Range ◽  
Funding Sources ◽  
Recipient Age ◽  
Group Serum ◽  
Phosphorus Levels

Abstract Background A higher serum phosphorus level, although within the normal range has been linked to coronary artery and aortic calcification in the non-transplant population. Coronary calcification is mostly associated with donor-derived lesions, and is uncommon within the first years after heart transplantation. Purpose We aimed to investigate the association of phosphorus levels with plaque calcification after heart transplantation. Methods A total of 156 patients who underwent virtual histology intravascular ultrasound (VH-IVUS) studies for cardiac allograft vasculopathy (CAV) surveillance and had fasting serum phosphorus levels <4.5 mg/dL, were included in the analyses. IVUS analyses were performed in the proximal left anterior descending artery, and plaque composition of dense calcium (DC) was evaluated using VH-IVUS, and presented as percent DC of total plaque volume. The patients were separated into 3 groups according to tertiles of serum phosphorus levels. Results Mean recipient and donor ages were 54±13 and 31±14 years, respectively. Mean serum phosphorus in recipients was 3.5±0.6 mg/dL, with median time after transplantation at the IVUS studies of 6 (3,10) years. There were no significant differences in %DC between phosphorus tertiles in patients who underwent IVUS within 6 years after transplantation (p=0.11, Fig. 1A). However, beyond 6 years after transplantation, we observed an incremental association between phosphorus levels and the extent of calcification (p=0.02, Fig. 1B). In this group, serum phosphorus levels significantly correlated with %DC (standardized β=0.29, P=0.008), and this correlation remained significant after adjustment for donor age, recipient age, and eGFR (standardized β=0.26, P=0.001). Conclusion Higher serum phosphorus levels were associated with a level-dependent increase in calcified coronary artery plaque in patients starting 6 years post heart transplant. Long-term exposure to higher serum phosphorus, even within the normal range, might promote plaque calcification after heart transplantation. FUNDunding Acknowledgement Type of funding sources: None.

Normal-range emergency department serum phosphorus levels and all-cause mortality

2020 ◽  
pp. postgradmedj-2019-137159
Author(s):  
Yiftach Barash ◽  
Eyal Klang ◽  
Shelly Soffer ◽  
Eyal Zimlichman ◽  
Avshalom Leibowitz ◽  
...  
Keyword(s):  
Emergency Department ◽  
Medical Center ◽  
Final Analysis ◽  
Hospitalisation Rate ◽  
Serum Phosphorus ◽  
Normal Range ◽  
Hospitalised Patients ◽  
All Cause Mortality ◽  
Clinical Consequences ◽  
Phosphorus Levels

Purpose of the studyHypophosphataemia and hyperphosphataemia are frequently encountered in hospitalised patients and are associated with significant clinical consequences. However, the prognostic value of normal-range phosphorus levels on all-cause mortality and hospitalisations is not well established. Therefore, we examined the association between normal-range phosphorus levels, all-cause mortality and hospitalisations in patients presenting to the emergency department of a tertiary medical centre in Israel.Study designA retrospective analysis of patients presenting to the Chaim Sheba Medical Center emergency department between 2012 and 2018. The cohort was divided into quartiles based on emergency department phosphorus levels: ‘very-low-normal’ (p ≥ 2 mg/dL and p ≤ 2.49 mg/dL), ‘low-normal’ (p ≥ 2.5 mg/dL and p ≤ 2.99 mg/dL), ‘high-normal’ (p≥  3 mg/dL and p≤3.49 mg/dL) and ‘very-high-normal’ (p ≥  3.5 mg/dL and p ≤ 4 mg/dL). We analysed the association between emergency department phosphorus levels, hospitalisation rate and 30-day and 90-day all-cause mortality.ResultsOur final analysis included 223 854 patients with normal-range phosphorus levels. Patients with ‘very-low-normal’ phosphorus levels had the highest mortality rate. Compared with patients with ‘high-normal’ phosphorus levels, patients with ‘very-low-normal’ levels had increased 30-day all-cause mortality (OR 1.3, 95% CI 1.1 to 1.4, p<0.001), and increased 90-day all-cause mortality (OR 1.2, 95% CI 1.1 to 1.3, p<0.001). Lower serum phosphorus levels were also associated with a higher hospitalisation rate, both for the internal medicine and general surgery wards (p<0.001).ConclusionsLower phosphorus levels, within the normal range, are associated with higher 30-day and 90-day all-cause mortality and hospitalisation rate.

scholarly journals Assessing Dietary Phosphorus Intake and Serum Phosphorus in Adults with Liver Conditions: NHANES 2015–2016

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 341-341
Author(s):  
Sowmiya Muthuraju ◽  
Derek Miketinas
Keyword(s):  
Liver Cancer ◽  
Cross Sectional Study ◽  
Serum Phosphorus ◽  
Cross Sectional ◽  
Funding Sources ◽  
Dietary Phosphorus ◽  
Usual Intake ◽  
Low Phosphorus ◽  
Phosphorus Intake ◽  
Phosphorus Levels

Abstract Objectives Patients with liver conditions may have increased phosphorus turnover which can increase the risk of severe hypophosphatemia and other complications. The objective of this cross-sectional study was to quantify the usual intake of phosphorus, assess serum phosphorus (SP) levels across levels of liver conditions, and to estimate and assess the odds for having critically low phosphorus levels across adults with and without liver conditions. Methods Data were obtained from the NHANES 2015–2016 cycle. Adults were divided into four groups based on self-reported responses from the NHANES medical history questionnaire: liver cancer (LC), unspecified current liver condition (CLC), unspecified resolved liver condition (RLC), and no liver condition. Usual intake was estimated using the NCI method and all analyses were adjusted to account for the complex, multistage, probability sampling design. Results Usual phosphorus intake was highest in participants with RLC (1399 ± 26.5 mg) and lowest in participants with LC (1267 ± 140.7 mg). Although the percentage of those meeting the EAR for phosphorus was high (&gt;95%), SP levels are lowest in participants with LC. SP levels differed slightly across liver conditions: participants with LC had a SP level of 1.0 ± 0.07 mmol/L, while participants with CLC, RLC, or no liver conditions had SP levels of 1.2 ± 0.01 mmol/L, 1.2 ± 0.01 mmol/L, and 1.2 ± 0.02 mmol/L, respectively. Participants with CLC had a usual phosphorus intake of 1350 ± 49.6 mg, and those who had no liver conditions had a usual phosphorus intake of 1387 ± 18.5 mg. The odds for normal phosphorus levels in participants with LC was low (Odds = 0.06; 95% CI: 0.01–0.45); the odds for CLC participants having normal SP levels was 1.6 (95% CI: 1.2–2.15); the odds for normal SP levels in participants with RLC were 2.2 (95% CI: 1.3–3.75), and the odds for normal SP in participants with no liver conditions odds for low were 1.9, (95% CI: 1.71–2.14). Conclusions These results indicate that patients with liver cancer are at higher risk of hypophosphatemia, and that phosphorus recommendations for patients with liver cancer may need to be adjusted. However, the variability in this subpopulation with liver cancer is high and warrants further investigation. Funding Sources None.

scholarly journals IMPACT OF MYOCARDIAL BRIDGING ON CORONARY ARTERY PLAQUE FORMATION AND LONG-TERM MORTALITY AFTER HEART TRANSPLANTATION

2015 ◽  
Vol 65 (10) ◽  
pp. A1741
Author(s):  
Shigemitsu Tanaka ◽  
Kozo Okada ◽  
Hideki Kitahara ◽  
Yuhei Kobayashi ◽  
Helen Luikart ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Heart Transplantation ◽  
Plaque Formation ◽  
Myocardial Bridging ◽  
Coronary Artery Plaque ◽  
Long Term Mortality

Long-Term Survival after Heart Transplantation: Interaction between Donor and Recipient Age

2019 ◽  
Vol 38 (4) ◽  
pp. S186
Author(s):  
A. Lechiancole ◽  
S. Sponga ◽  
V. Ferrara ◽  
C. Nalli ◽  
C. Di Nora ◽  
...  
Keyword(s):  
Heart Transplantation ◽  
Term Survival ◽  
Long Term Survival ◽  
Recipient Age

scholarly journals Multicenter Prospective Cohort on Aortic Valve Stenosis in Japanese Patients With End Stage Kidney Disease in Tokai Region (ASKIT)

2021 ◽  
Author(s):  
Yuji Sasakawa ◽  
Naoki Okamoto ◽  
Maya Fujii ◽  
Jyoichiro Kato ◽  
Yukio Yuzawa ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Odds Ratio ◽  
Elevated Serum ◽  
Serum Phosphorus ◽  
Aortic Valve Calcification ◽  
Logistic Analysis ◽  
Multivariate Logistic Analysis ◽  
Multicenter Prospective Cohort ◽  
Phosphorus Levels

Abstract Background:The prevalence of aortic valve stenosis (AS) in patients on maintenance dialysis is high and the prognosis is poor. Because only few large cohort studies have analyzed patients with AS on dialysis, the factors that cause AS in such patients remain unclear.Methods:This multicenter, prospective cohort study included 2,786 patients on dialysis who underwent transthoracic echocardiography between July 1, 2017 and June 30, 2018. Patients with a maximum aortic jet velocity (Vmax) ≥2.0 m/s, pressure gradient (PG) between the left ventricle and ascending aorta (mean PG) ≥20 mmHg, or aortic valve area (AVA) ≤1.0 cm2 were categorized into the AS group. Of these, patients with Vmax ≥3.0 m/s, mean PG ≥20 mmHg, or AVA ≤1.0 cm2 were categorized into the severe AS group. The AS and severe AS groups were then compared with the non-AS group to identify the risk factors for AS using multivariate logistic analysis. We also compared the risk factors for AS with and without aortic valve calcification, which is the stage prior to age-related AS.Results:Of the 2,786 patients analyzed, 555 (20.0%) and 139 (6.9%) were categorized into the AS and severe AS groups, respectively. Multivariate logistic analysis revealed that aging, long-term dialysis, and elevated serum phosphorus levels were associated with AS in the AS and severe AS groups (p <0.05). Additional investigation using stratified multivariate analysis revealed that groups with serum phosphorus levels of 5.0–5.9 mg/dL and >6.0 mg/dL had a higher risk of AS than those with serum phosphorus levels of <4.0 mg/dL (odds ratio: 2.24; p = 0.01 and odds ratio: 2.66, p = 0.005, respectively). Aortic valve calcification was associated with aging, long-term dialysis, diabetes mellitus, administration of vitamin D receptor activators, elevated serum calcium levels, and anemia (p <0.05 for all).Conclusions:Dialysis patients had a high prevalence of AS, and AS was associated with aging, long dialysis duration, and elevated serum phosphorus levels.Trial registration: UMIN000026756, Registered on March 29, 2017.

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