Inorganic phosphate and FGF-23 predict outcome in stable systolic heart failure

Eur J Clin Invest 2012; 42 (6): 649–656 Background Recent studies show associations between inorganic phosphate and risk of heart failure in the general population as well as between fibroblast growth factor 23 (FGF‐23) and outcome in coronary heart disease. This study was carried out to assess whether circulating levels of inorganic phosphate and FGF‐23, a new central hormone in mineral bone metabolism, predict outcome in systolic heart failure. Materials and methods Ninety‐nine consecutive outpatients with systolic heart failure were enrolled. Mean (SD) age was 61 years (11), mean left ventricular ejection fraction (LVEF) was 33% (10), 82 patients were men, median estimated creatinine clearance was 83 mL/min (Q1–Q3 58–106), median NTproBNP level was 803 pg/mL (Q1–Q3 404–2757), median inorganic phosphate was 1·12 mM (Q1–Q3 1·02–1·22), median FGF‐23 was 39·02 pg/mL (Q1–Q3 32·45–55·86) and median follow‐up was 35 months. Associations between inorganic phosphate, FGF‐23 and endpoints were assessed using Cox regression analyses. Results Inorganic phosphate and FGF‐23 levels were significantly higher (P