The associations of fibroblast growth factor 23 and uncarboxylated matrix Gla protein with mortality in coronary artery disease: the Heart and Soul Study.
The associations of fibroblast growth factor 23 and uncarboxylated matrix Gla protein with mortality in coronary artery disease: the Heart and Soul Study.
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DOI：
10.7326/0003-4819-152-10-201005180-00004
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发表时间：
2010-05-18
影响因子：
39.2
通讯作者：
Ix JH
中科院分区：
文献类型：
--
作者：
Parker BD;Schurgers LJ;Brandenburg VM;Christenson RH;Vermeer C;Ketteler M;Shlipak MG;Whooley MA;Ix JH
成纤维细胞生长因子23(FGF23)、非羧化基质GLA蛋白(UcMGP)和胎球蛋白-A是矿物质代谢的调节因子和血管钙化的抑制因子。在没有终末期肾脏疾病的人群中，循环中的每一种物质的水平是否与心血管疾病(CVD)事件或死亡率相关尚不清楚。评估FGF23、ucMGP和胎球蛋白-A与死亡率和心血管事件的关系。观察性研究。旧金山湾区的12家门诊诊所。自2000年9月11日至2002年12月20日共收治833例稳定性冠状动脉疾病(CAD)患者。基线时测定成纤维细胞生长因子23、ucMGP和胎球蛋白-A的浓度。参与者被跟踪调查至2008年12月1日，观察死亡率和心血管事件。在中位数为6.0年的随访中，220名参与者死亡，182人发生心血管事件。在调整了传统的心血管危险因素、C反应蛋白水平和肾功能后，与水平最低的三分位数的参与者相比，三分位数最高的参与者的死亡率(危险比[HR]，2.15[95%CI，1.43至3.24])和心血管事件(HR，1.83[CI，1.15至2.91])增加了2倍。最高的ucMGP三分率与较低的死亡风险(HR，0.48[CI，0.31至0.75])相关，并通过三分分析显示出较低的心血管事件风险(HR，0.65[CI，0.40至1.05])--这种关联在连续建模时显著(P=0.029)。未观察到胎球蛋白-A与死亡率(HR，0.84[CI，0.55至1.27])或心血管事件(HR，0.99[CI，0.64至1.55])显著相关。参与者患有普遍的冠心病。在冠心病稳定的门诊患者中，较高的FGF23和较低的ucMGP水平与死亡率和心血管事件独立相关。美国心脏协会。
Fibroblast growth factor 23 (FGF23), uncarboxylated matrix Gla protein (ucMGP), and fetuin-A are regulators of mineral metabolism and inhibitors of vascular calcification. Whether circulating levels of each are associated with cardiovascular disease (CVD) events or mortality in populations without end-stage renal disease is unknown. To evaluate the associations of FGF23, ucMGP, and fetuin-A with mortality and CVD events. Observational study. 12 outpatient clinics in the San Francisco Bay area. 833 outpatients with stable coronary artery disease (CAD), recruited from 11 September 2000 to 20 December 2002. Fibroblast growth factor 23, ucMGP, and fetuin-A concentrations were measured at baseline. Participants were followed until 1 December 2008 for mortality and CVD events. During a median follow-up of 6.0 years, 220 participants died and 182 had CVD events. Compared with participants with FGF-23 levels in the lowest tertile, those in the highest tertile had 2-fold greater risk for mortality (hazard ratio [HR], 2.15 [95% CI, 1.43 to 3.24]) and CVD events (HR, 1.83 [CI, 1.15 to 2.91]) after adjustment for traditional CVD risk factors, C-reactive protein levels, and kidney function. The highest ucMGP tertile was associated with lower mortality risk (HR, 0.48 [CI, 0.31 to 0.75]) and showed a nonsignificant trend toward lower CVD event risk by tertile analysis (HR, 0.65 [CI, 0.40 to 1.05])—an association that was significant when modeled continuously (P = 0.029). No significant association of fetuin-A with mortality (HR, 0.84 [CI, 0.55 to 1.27]) or CVD events (HR, 0.99 [CI, 0.64 to 1.55]) was observed. Participants had prevalent CAD. In outpatients with stable CAD, higher FGF23 and lower ucMGP levels are independently associated with mortality and CVD events. American Heart Association.
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DOI：
10.1056/nejmoa0706130
发表时间：
2008-08-07
期刊：
The New England journal of medicine
影响因子：
--
作者：
Gutiérrez OM;Mannstadt M;Isakova T;Rauh-Hain JA;Tamez H;Shah A;Smith K;Lee H;Thadhani R;Jüppner H;Wolf M
通讯作者：
Wolf M
影响因子：
4.8
作者：
Heiss, A;DuChesne, A;Jahnen-Dechent, W
通讯作者：
Jahnen-Dechent, W
影响因子：
4.8
作者：
Foley, Robert N.;Collins, Allan J.;Kalra, Philip A.
通讯作者：
Kalra, Philip A.
影响因子：
13.6
作者：
Kestenbaum, B;Sampson, JN;Andress, DL
通讯作者：
Andress, DL
影响因子：
37.8
作者：
Hagstrom, Emil;Hellman, Per;Arnlov, Johan
通讯作者：
Arnlov, Johan