Faculty Opinions recommendation of Parathyroid hormone and vitamin D--markers for cardiovascular and all cause mortality in heart failure.

Background: Previous studies have indicated that parathyroid hormone (PTH) has been linked to post-myocardial infarction (MI) development. The aim of this cross-sectional study was to evaluate the relationship between PTH level and heart failure due to post infarction remodeling during the first 72 hours of hospitalization. Methods: Seventy patients with a diagnosis of acute MI (age ≥18 years, 22 females and 48 males) were enrolled. Patients were admitted to the Imam Raza Educational, Research and Treatment Center, Mashhad University of Medical Sciences, Iran between July 2014 to September 2015. We measured PTH and vitamin D level. Blood samples were taken after 24 hours and 72 hours. Results: During the first 72 hours, the PTH level significantly increased in patients with Post-MI heart failure. 68% of the subjects had an inappropriate vitamin D level at the time of admission. Mean levels of vitamin D and PTH increased compared with the baselines (95% CI, 0.15 to 10.03, P: 0.044), (95% CI, 6.5 to 24.8, P:0.001) respectively. Conclusion: Acute elevations of serum PTH levels increased early remodeling heart failure after MI. Serum vitamin D status was independent of high serum PTH level. Based on the current evidence, PTH excess may be a risk factor for heart failure, so early treatment and omitting risk factors are the most effective strategies for the patients with acute myocardial infarction. J Pharm Care 2020; 8(1): 11-15.

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Study of Parathyroid Hormone as an Independent Risk Marker of Heart Failure

Indian Journal of Medical Biochemistry ◽

10.5005/jp-journals-10054-0041 ◽

2017 ◽

Vol 21 (2) ◽

pp. 157-161

Author(s):

Krishna M Iyyapu ◽

Sreekanth Yerram ◽

Kompella SS Sai Baba

Keyword(s):

Heart Failure ◽

Vitamin D ◽

Parathyroid Hormone ◽

Odds Ratio ◽

Nyha Class ◽

Clinical Syndrome ◽

Study Group ◽

Risk Marker ◽

High Concentration ◽

Cross Sectional

ABSTRACT Introduction Heart failure (HF) is a clinical syndrome characterized by cardiac pump failure with signs and symptoms arising from salt and water retention. Heart failure is associated with considerable mortality and morbidity. Identification of modifiable risk factors may reduce incidence of HF and its complications. The aim of our study is to assess parathyroid hormone (PTH) as a risk marker for HF and its association with severity of HF. Materials and methods In this cross-sectional study, 120 subjects with HF were recruited and they were compared with 60 age- and sex-matched controls. Along with the routine parameters, N-terminal pro B-type natriuretic peptide (NT-proBNP), intact PTH, and vitamin D were estimated. The study group was divided into quartiles depending on PTH value. Results The median PTH (81.5 pg/mL) and NT-proBNP (3753 pg/mL) in HF patients are found to be significantly higher (p < 0.0001) when compared with control subjects. The median vitamin D concentration (18 ng/mL) though low in cases is not statistically significant when compared with controls. Demographic, clinical, and laboratory characteristics are compared across the quartiles of PTH. Highest number of New York Heart Association (NYHA) class IV HF cases are found in highest quartiles of PTH. Logistic regression analysis demonstrated that high concentration of PTH [odds ratio of 1.1113; 95% confidence interval (CI) 1.07—1.14; p < 0.0001] and low levels of vitamin D (odds ratio of 1.053; 95% CI 1.0079—1.1009) are significantly associated with HF. Conclusion This study has demonstrated that higher concentration of PTH is associated with severe form of HF. Vitamin D deficiency is also seen in the study group. How to cite this article Khan SA, Iyyapu KM, Sai Baba KSS, Yerram S. Study of Parathyroid Hormone as an Independent Risk Marker of Heart Failure. Indian J Med Biochem 2017;21(2):157-161.

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Sex-Specific Relationship Between Parathyroid Hormone and Platelet Indices in Phenotypes of Heart Failure—Results From the MyoVasc Study

Frontiers in Cardiovascular Medicine ◽

10.3389/fcvm.2021.682521 ◽

2021 ◽

Vol 8 ◽

Author(s):

Bianca Dahlen ◽

Felix Müller ◽

Sven-Oliver Tröbs ◽

Marc William Heidorn ◽

Andreas Schulz ◽

...

Keyword(s):

Heart Failure ◽

Vitamin D ◽

Platelet Count ◽

Parathyroid Hormone ◽

Ejection Fraction ◽

Vitamin D Status ◽

Linear Regression Models ◽

Platelet Indices ◽

Reduced Ejection Fraction ◽

Potential Marker

Background: Heart failure (HF) is a multifactorial syndrome with pathophysiological complexities still not fully understood. Higher mean platelet volume (MPV), a potential marker of platelet activation, and high concentrations of parathyroid hormone (PTH) have been implicated in the pathogenesis of HF.Aim: This study aims to investigate sex-specifically the association between PTH concentrations and platelet indices in phenotypes of HF.Methods and Results: PTH and platelet indices (MPV and platelet count) were available in 1,896 participants from the MyoVasc study in Mainz, Germany. Multivariable linear regression models, adjusted for age, sex, season, vitamin D status, cardiovascular risk factors, comorbidities, estimated glomerular filtration rate, and medication, were used to assess the associations between platelet indices and PTH. The results showed distinct sex-specific associations between PTH and platelet indices. A positive association between PTH and MPV was found in females with symptomatic HF with reduced ejection fraction (HFrEF) only [β = 0.60 (0.19; 1.00)]. Platelet count was inversely associated with PTH in male HFrEF individuals [β = −7.6 (−15; −0.30)] and in both males and females with HF with preserved ejection fraction (HFpEF).Conclusion: This study reports differential, sex-specific relationships between PTH and platelet indices in HF individuals independent of vitamin D status and clinical profile. Particularly in phenotypes of symptomatic HF, distinct associations were observed, suggesting a sex-specific mechanism involved in the interaction between PTH and platelets.

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Elevated Parathyroid Hormone, But Not Vitamin D Deficiency, Is Associated With Increased Risk of Heart Failure in Older Men With and Without Cardiovascular Disease

Circulation Heart Failure ◽

10.1161/circheartfailure.114.001272 ◽

2014 ◽

Vol 7 (5) ◽

pp. 732-739 ◽

Cited By ~ 42

Author(s):

S. Goya Wannamethee ◽

Paul Welsh ◽

Olia Papacosta ◽

Lucy Lennon ◽

Peter H. Whincup ◽

...

Keyword(s):

Heart Failure ◽

Cardiovascular Disease ◽

Vitamin D ◽

Parathyroid Hormone ◽

Vitamin D Deficiency ◽

Older Men ◽

Increased Risk

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Vitamin D, Parathyroid Hormone, and Heart Failure in a Chinese Elderly Population

Endocrine Practice ◽

10.4158/ep14123.or ◽

2015 ◽

Vol 21 (1) ◽

pp. 30-40 ◽

Cited By ~ 4

Author(s):

Yi Li ◽

Chen Chen ◽

Hui Liu ◽

Geng Qian

Keyword(s):

Heart Failure ◽

Vitamin D ◽

Parathyroid Hormone ◽

Elderly Population ◽

Chinese Elderly

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Serum Parathyroid Hormone Predicts Mortality in Coronary Angiography Patients with Type 2 Diabetes

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgaa512 ◽

2020 ◽

Vol 105 (11) ◽

Author(s):

Eva Maria Brandtner ◽

Axel Muendlein ◽

Andreas Leiherer ◽

Franz Paul Armbruster ◽

Thomas Bernd Dschietzig ◽

...

Keyword(s):

Type 2 Diabetes ◽

Vitamin D ◽

Parathyroid Hormone ◽

Coronary Angiography ◽

Mortality Risk ◽

Serum Levels ◽

All Cause Mortality ◽

Serum Pth ◽

The Impact

Abstract Background Elevated serum levels of parathyroid hormone (PTH), one of the main regulators of calcium homeostasis and vitamin D metabolism, have been proposed as predictors of mortality. The impact of type 2 diabetes mellitus (T2DM) on the putative association between PTH and mortality has not been investigated thus far. Aim The aim of our study was to investigate the impact of T2DM on the power of PTH to predict mortality risk. Methods Serum PTH levels were determined in 904 consecutive Caucasian patients referred to coronary angiography for the evaluation of established or suspected stable coronary artery disease (CAD), including 235 patients with T2DM. Prospectively, deaths were recorded over a mean follow-up period of 6.3 years. Results PTH at baseline did not differ significantly between patients with and without T2DM (P = .307). Cox regression analysis revealed that the serum PTH level strongly predicted all-cause mortality in patients with T2DM (hazard ratio [HR] = 2.35 [1.37-4.03]; P = .002), whereas PTH did not predict all-cause mortality in patients without T2DM (HR = 1.04 [0.81-1.32]; P = .766). The interaction term PTH × T2DM was significant (P = .006), indicating a significantly stronger impact of PTH on mortality risk in patients with T2DM than in individuals without diabetes. The impact of PTH on mortality risk in patients with T2DM remained significant after adjustment for glycated hemoglobin A1c, diabetes duration, classical cardiovascular risk factors, serum levels of vitamin D, and kidney function (HR = 2.10 [1.10-4.10]; P = .030). Conclusion We conclude that PTH is a significantly stronger predictor of all-cause mortality in patients with T2DM than in those without T2DM.

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