Abstract P349: Association Of Fibroblast Growth Factor 23 With Incident Cardiovascular Disease And All-Cause Mortality In The Framingham Heart Study

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Robin Haring ◽  
Ramachandran S Vasan ◽  
Henri Wallaschofski ◽  
Lisa Sullivan ◽  
Danielle Enserro

Objective: To investigate the association of fibroblast growth factor 23 (FGF23) with incident cardiovascular disease (CVD) and mortality risk in the general population. Methods: We evaluated 3,236 Framingham Offspring and Omni Study participants to examine the associations of serum FGF23 (measured by immunoassay) with 10-year incident CVD (N = 2,823) and all-cause mortality (N = 3,223) using multivariable Cox regression models. Results: During a median follow-up time of 10.8 years (Q1, 10.0; Q3, 11.4), 347 participants developed new-onset CVD and 412 died. Age- and sex-adjusted Cox regression models revealed a positive association of FGF23 with incident CVD (hazard ratio (HR) per unit increase in logFGF23: 1.43, 95% confidence interval (CI) 1.11-1.84) and all-cause mortality (HR 2.26, 95% CI, 1.86-2.75). After multivariable adjustment, the association of FGF23 with incident CVD was rendered non-significant (HR 1.12, 95% CI 0.86-1.46), whereas the positive association of FGF23 with all-cause mortality was maintained (HR: 1.87, 95% CI: 1.52 - 2.29). Analyses modeling FGF23 quartiles yielded similar findings (multivariable-adjusted HR Q4 vs. Q1 for incident CVD: 1.17, 95% CI: 0.87 - 1.59; for death: 1.87, 95% CI: 1.38 - 2.53). Conclusion: In our large community-based sample, serum FGF23 shows an independent positive association with all-cause mortality, but not with incident CVD risk.

Author(s):  
Shejuti Paul ◽  
Mandy Wong ◽  
Ehimare Akhabue ◽  
Rupal C. Mehta ◽  
Holly Kramer ◽  
...  

Background Higher circulating fibroblast growth factor 23 (FGF23) associates with greater risk of cardiovascular disease (CVD) and mortality in older adults. The association of FGF23 with cardiovascular outcomes in younger populations has been incompletely explored. Methods and Results We measured C‐terminal FGF23 (cFGF23) and intact FGF23 (iFGF23) in 3151 middle‐aged adults (mean age, 45±4) who participated in the year 20 examination of the CARDIA (Coronary Artery Risk Development in Young Adults) study. We used separate Cox proportional hazards models to examine the associations of cFGF23 and iFGF23 with incident CVD and mortality, adjusting models sequentially for sociodemographic, clinical, and laboratory factors. A total of 157 incident CVD events and 135 deaths occurred over a median 7.6 years of follow‐up (interquartile range, 4.1–9.9). In fully adjusted models, there were no statistically significant associations of FGF23 with incident CVD events (hazard ratio per doubling of cFGF23: 1.14, 95%CI 0.97,1.34; iFGF23: 0.76, 95%CI 0.57,1.02) or all‐cause mortality (hazard ratio per doubling of cFGF23, 1.17; 95% CI, 1.00–1.38; iFGF23, 0.86; 95% CI, 0.64–1.17). In analyses stratified by CVD subtypes, higher cFGF23 was associated with greater risk of heart failure hospitalization (hazard ratio per doubling of cFGF23, 1.52; 95% CI, 1.18–1.96) but not coronary heart disease or stroke, whereas iFGF23 was not associated with CVD subtypes in any model. Conclusions In middle‐aged adults with few comorbidities, higher cFGF23 and iFGF23 were not independently associated with greater risk of CVD events or death. Higher cFGF23 was independently associated with greater risk of heart failure hospitalization.


2011 ◽  
Vol 165 (5) ◽  
pp. 797-803 ◽  
Author(s):  
Mansi Dalal ◽  
Kai Sun ◽  
Anne R Cappola ◽  
Luigi Ferrucci ◽  
Candace Crasto ◽  
...  

ObjectiveAlthough fibroblast growth factor 23 (FGF23) has been implicated in the pathogenesis of cardiovascular disease, the relationship between FGF23 and cardiovascular disease has not been well characterized in the general population. The aim of this study was to determine whether serum FGF23 is independently associated with cardiovascular disease in older community-dwelling women.Design and methodsA cross-sectional design was used to examine the relationship between serum FGF23 and cardiovascular disease. The subjects consisted of a population-based sample of 659 women, aged 70–79 years, who participated in the Women's Health and Aging Studies in Baltimore, Maryland. Prevalent cardiovascular disease (coronary heart disease, stroke, congestive heart failure, and peripheral artery disease) was assessed through diagnostic algorithms and physician adjudication.ResultsOf the 659 women, 185 (28.1%) had cardiovascular disease. Median (25th, 75th percentile) intact serum FGF23 was 34.6 (25.2, 46.2) pg/ml. The prevalence of cardiovascular disease in the lowest, middle, and highest tertile of serum FGF23 was 22.6, 24.9, and 36.7% respectively (P=0.002). Serum log FGF23 was associated with cardiovascular disease (odds ratio per 1s.d.increase=1.23, 95% confidence interval 1.17, 1.30;P<0.0001) in a multivariable logistic regression model, adjusting for age, race, smoking, education, body mass index, cognition, diabetes, hypertension, physical activity, total cholesterol, high-density lipoprotein cholesterol, and renal function.ConclusionElevated serum FGF23 concentrations are independently associated with prevalent cardiovascular disease in older community-dwelling women. Further studies are needed to elucidate the potential biological mechanisms by which FGF23 may be involved in the pathogenesis of cardiovascular disease.


2018 ◽  
Vol 32 (1) ◽  
pp. 18-25 ◽  
Author(s):  
Ehimare Akhabue ◽  
Thanh-Huyen T Vu ◽  
Anand Vaidya ◽  
Erin D Michos ◽  
Ian H de Boer ◽  
...  

Abstract BACKGROUND Higher fibroblast growth factor-23 (FGF23) concentrations have been found to be associated with incident heart failure (HF). Experimental data suggest FGF23 directly stimulates myocardial hypertrophy. FGF23 may also enhance renin–angiotensin–aldosterone system activity. Whether FGF23 is associated with increased HF risk in populations with hypertension and whether this association is weaker in the presence of angiotensin-converting enzyme inhibitor (ACEI) or angiotensin II receptor blocker (ARB) therapy is unknown. METHODS We studied 2,858 adults with hypertension free of cardiovascular disease at baseline (65.6 ± 9.5 years, 46.2% male) participating in the Multi-Ethnic Study of Atherosclerosis (MESA). We investigated the association of baseline serum intact FGF23 with incident HF over a 14-year median follow-up and whether ACEI/ARB therapy modified this risk. We also investigated the relationship of FGF23 with aldosterone and plasma renin activity in a random subgroup of the entire MESA cohort with available assays (N = 1,642). RESULTS In adjusted Cox regression models, higher FGF23 was associated with a 63% greater hazard of incident HF (hazard ratio: 1.63, 95% confidence interval: [1.13–2.36] per 1-unit increase in log-transformed FGF23), which persisted after exclusion of participants with chronic kidney disease (hazard ratio: 1.94 [1.10–3.43]). There was no heterogeneity by ACEI/ARB use (Pinteraction = 0.438). FGF23 improved model fit over covariables (likelihood ratio χ2 = 6.67, P = 0.010). In multivariable linear regression models, there was no association between FGF23 and aldosterone or plasma renin activity. CONCLUSIONS Higher FGF23 concentrations are associated with a significantly increased risk of HF in hypertension but this risk did not differ by ACEI/ARB treatment status. FGF23 may be a useful biomarker for HF risk in hypertensive populations.


Circulation ◽  
2015 ◽  
Vol 132 (1) ◽  
pp. 27-39 ◽  
Author(s):  
Sharon M. Moe ◽  
Glenn M. Chertow ◽  
Patrick S. Parfrey ◽  
Yumi Kubo ◽  
Geoffrey A. Block ◽  
...  

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