Serum intact parathyroid hormone levels predict hospitalisation for heart failure.

Abstract

To assess whether circulating levels of intact parathyroid hormone (intact PTH) in outpatients predict hospitalisation for heart failure (HF). Eighty-eight consecutive outpatients with HF were enrolled in the study. The independent association between intact PTH and hospitalisation for HF was assessed using Cox regression analysis. Mean (SD) serum intact PTH levels significantly increased as New York Heart Association classes increased (I: 40 (21), II: 55 (24), III: 76 (46), IV: 131 (45) pg/ml). The receiver operating characteristic (ROC) curves showed intact PTH levels >or=47 pg/ml to be the optimal cut-off points for hospitalisation for HF, with sensitivity 87%, specificity 71% and area under the ROC curve 0.82 (95% CI 0.72 to 0.91). After adjustment for variables accepted to be predictors for hospitalisation due to HF (age, gender, hypertension, diabetes mellitus, atrial fibrillation, ischaemic heart disease, left ventricular ejection fraction, B-type natriuretic peptide, estimated glomerular filtration rate and cardiac drugs), intact PTH levels >or=47 pg/ml were associated with a hazard ratio of 7.13 for hospitalisation for HF (95% CI 1.79 to 28.4). Serum intact PTH levels obtained in outpatients with HF were shown to be an independent predictor of hospitalisation for HF.