Fibroblast growth factor 23 is a strong independent marker of poor outcome after an acute coronary syndrome

• Published in: European heart journal 2023-11, Vol.44 (Supplement_2)
• Main Authors: Kallmeyer, A, Pello, A, Canovas, E, Acena, A, Gonzalez-Casaus, M L, Tarin, N, Cristobal, C, Gutierrez-Landaluce, C, Huelmos, A, Rodriguez-Valer, A, Gonzalez Lorenzo, O, Alonso, J, Mahillo, I, Lorenzo, O, Tunon, J
• Format: Article
• Language: English
• ISSN: 0195-668X; 1522-9645
• DOI: 10.1093/eurheartj/ehad655.1338

Our study aimed to assess the role of fibroblast growth factor 23 (FGF-23) as a prognostic marker after an acute coronary syndrome (ACS). It was a prospective and multicentric study, performed at five tertiary hospitals in our city, which included 1,190 patients with ACS. FGF-23 plasma levels and other components of mineral metabolism (calcidiol, parathormone [PTH], klotho, and phosphate), lipids, troponin, high-sensitivity C-reactive protein, and N-terminal-pro-brain natriuretic peptide were measured at discharge. The primary outcome was a combination of acute ischemic events, heart failure (HF) and death. Secondary outcomes were the separate components of the primary outcome. Median follow-up was 5.44 (3.03-7.46) years. 294 patients developed the primary outcome. Patients with FGF-23 less than median (which was settled in 110 RU/mL) were less frequently females, and were younger and had a lower load of cardiovascular risk factors. Besides, calcidiol and PTH levels were lower in patients with FGF-23 below the median. Multivariable analysis showed that FGF-23 (HR 1.18 [1.08-1.29], p