C-terminal FGF23 is a strong predictor of survival in systolic heart failure

► Fibroblast growth factor 23 is an important of phosphate and calcium metabolism. ► C-terminal FGF23 is a 71 amino acids peptide. ► We have evaluated Ct-FGF23 in patients presenting systolic heart failure. ► Ct-FGF23 levels were markedly increased in HF patients. ► Ct-FGF23 is the strongest predictor of long term CV death. Fibroblast growth factor 23 (FGF23) is a bone-derived hormone involved in the regulation of phosphate and calcium metabolism. We have evaluated the levels of C-terminal FGF23 (Ct-FGF23) in 73 patients presenting heart failure with reduced ejection fraction (HF-REF) and assess their potential predictive value for long-term survival through a 6years follow-up. Ct-FGF23 levels were markedly increased in HF-REF. In univariate proportional hazard model, survival was related to glomerular filtration rate (eGFR), intact parathyroid hormone (PTH), B-type natriuretic peptides (BNP) and Ct-FGF23. In a multivariate analysis including age, EF, PTH, BNP, Ct-FGF23, calcium, phosphorus and eGFR levels, Ct-FGF23 is the strongest predictor of long term CV death.