Serum levels of C-terminal FGF23 (cFGF23) are associated with 1-year-mortality in patients undergoing transcatheter aortic valve replacement (TAVR)
- Resource Type
- Authors
- Christian Jung; Michael Lichtenauer; Peter Jirak; Richard Rezar; Hermann Salmhofer; Brunilda Alushi; Thomas K. Felder; Moritz Mirna; Vera Paar; Alexander Lauten; Bernhard Wernly; Uta C. Hoppe; Lukas J. Motloch
- Source
- European journal of internal medicine. 85
- Subject
- medicine.medical_specialty
Transcatheter aortic
medicine.medical_treatment
Urology
Renal function
030204 cardiovascular system & hematology
Transcatheter Aortic Valve Replacement
03 medical and health sciences
Impaired renal function
chemistry.chemical_compound
0302 clinical medicine
Valve replacement
Internal Medicine
Medicine
Humans
In patient
030212 general & internal medicine
Renal Insufficiency
Retrospective Studies
Creatinine
business.industry
Proportional hazards model
Aortic Valve Stenosis
Fibroblast Growth Factor-23
Treatment Outcome
chemistry
Aortic Valve
business
1 year mortality
Glomerular Filtration Rate
- Language
- ISSN
- 1879-0828
Serum levels of FGF23 have been associated with adverse outcomes in cardiovascular diseases in patients with and without impaired renal function. Hence, this study aimed to explore the prognostic relevance of intact FGF23 (iFGF23) and its derivate C-terminal FGF23 (cFGF23) in patients undergoing transcatheter aortic valve replacement (TAVR) with regard to renal function.A total of 274 patients undergoing transfemoral TAVR were enrolled in this study. Blood samples were obtained preinterventionally and analyzed for iFGF23 and cFGF23 by means of enzyme linked immunosorbent assay (ELISA). Follow-up was obtained for 12 months.Serum levels of cFGF23 and iFGF23 both correlated positively with serum creatinine and inversely with estimated glomerular filtration rate (eGFR). Cox regression analysis revealed a significant association of cFGF23 with 1-year-mortality in patients with eGFR ≥45ml/min/1.73m², but not in patients with an eGFR45ml/min/1.73m². A cut-off was calculated for cFGF23 (6.82 pmol/l) and patients with eGFR ≥45ml/min/1.73m² were retrospectively divided into two groups (above/below cut-off). Patients above the cut-off had a significantly worse 1-year-mortality than patients below the cut-off (33.3% vs. 19.6%; OR 2.05 (95%CI 1.03-4.07), p= 0.038). The association of cFGF23 with 1-year-mortality in patients with eGFR ≥45ml/min/1.73m² remained statistically significant even after correction for possible confounders in a multivariate Cox regression analysis.cFGF23 could be an individual risk factor for mortality in patients undergoing TAVR with an eGFR ≥45ml/min/1.73m².