Association between phosphate and long-term outcome in CAD patients underwent coronary intervention

• Published in: Scientific reports 2021-10, Vol.11 (1), p.20080-20080, Article 20080
• Main Authors: Tsai, Tsung-Ying, Hsu, Pai-Feng, Wu, Cheng-Hsueh, Yang, Ya-Ling, Chen, Su-Chan, Huang, Shao-Sung, Chan, Wan Leong, Lin, Shing-Jong, Chen, Jaw-Wen, Pan, Ju-Pin, Charng, Min-Ji, Chen, Ying-Hwa, Wu, Tao-Cheng, Lu, Tse-Min, Huang, Po-Hsun, Cheng, Hao-Min, Huang, Chin-Chou, Sung, Shih-Hsien, Lin, Yenn-Jiang, Leu, Hsin-Bang
• Format: Article
• Language: English
• Subjects: 692/4019; 692/4019/2776; Aged; Cardiovascular disease; Cardiovascular diseases; Congestive heart failure; Coronary artery; Coronary Artery Disease - mortality; Coronary Artery Disease - pathology; Coronary Artery Disease - therapy; Female; Humanities and Social Sciences; Humans; Implants; Low density lipoprotein; Male; multidisciplinary; Percutaneous Coronary Intervention - adverse effects; Phosphate; Phosphates; Phosphates - administration & dosage; Phosphates - adverse effects; Renal function; Retrospective Studies; Risk Assessment; Risk Factors; Science; Science (multidisciplinary); Stents; Stents - adverse effects; Stroke - etiology; Stroke - mortality; Stroke - pathology; Survival Rate; Treatment Outcome
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-021-99518-z

Phosphate has been linked to higher cardiovascular (CV) risk. However, whether phosphate is associated with poor outcomes for patients with coronary artery disease (CAD) after percutaneous coronary interventions (PCIs) remained undetermined. 2,894 CAD patients (2,220 male, aged 71.6 ± 12.2), who received PCI at TVGH from 2006 to 2015, with phosphate measurement, were enrolled. The primary outcome was the composite of major adverse CV events [MACE, comprising of CV death, nonfatal MI, and nonfatal stroke] and heart failure hospitalization (HHF). The key secondary outcome was MACE. There was a J-curve association between phosphate and CV events after adjusted for comorbidities and renal function. Phosphate around 3.2 ± 0.1 mg/dL was associated with the lowest CV risk. In Cox analysis, each 1 mg/dL increases in phosphate was associated with a higher risk of MACE + HHF (HR: 1.12, 95% CI: 1.05–1.21): CV death (HR: 1.37, 95% CI: 1.22–1.55) and HHF (HR: 1.12, 95% CI: 1.02–1.23). Subgroup analyses showed more prominent association between phosphate and MACE + HHF in male, age > 65, bare-metal stents (BMSs), LVEF