RT Journal Article
SR Electronic
T1 Calcium, phosphate and the risk of cardiovascular events and all-cause mortality in a population with stable coronary heart disease
JF Heart
JO Heart
FD BMJ Publishing Group Ltd and British Cardiovascular Society
SP 926
OP 933
DO 10.1136/heartjnl-2011-300806
VO 98
IS 12
A1 Grandi, Norma Christine
A1 Brenner, Hermann
A1 Hahmann, Harry
A1 Wüsten, Bernd
A1 März, Winfried
A1 Rothenbacher, Dietrich
A1 Breitling, Lutz Philipp
YR 2012
UL http://heart.bmj.com/content/98/12/926.abstract
AB Objective High serum calcium and phosphate levels have been linked to cardiovascular diseases and all-cause mortality but evidence from longitudinal studies is scarce, especially among patients with pre-existing coronary heart disease. The association between baseline calcium and phosphate and prognosis was examined in a cohort study of patients with stable coronary heart disease.Methods Serum calcium and phosphate were measured in a cohort of initially 1206 patients undergoing a 3 week rehabilitation programme after an acute cardiovascular event and subsequently being followed-up for 8 years. Multivariate Cox regression was employed to assess the association of quartiles and continuous levels of calcium and phosphate with secondary cardiovascular events and all-cause mortality.Results No significant risk elevations were observed for secondary cardiovascular event incidence in models adjusted for a variety of potential confounders. High calcium levels, however, were strongly associated with mortality risk in adjusted models (HRQ4vsQ1=2.39 (1.22 to 4.66)). In additional multivariable analyses, the calcium/albumin ratio was predictive for all-cause mortality (HRQ4vsQ1=2.66 (1.35 to 5.22)) and marginally predictive for cardiovascular event incidence (HRQ4vsQ1=1.74 (1.00 to 3.05)).Conclusions Calcium and the ratio of calcium with albumin, its major binding protein, were strongly associated with all-cause mortality among patients with coronary heart disease. The underlying mechanisms and the clinical implications of these findings deserve further study.