Abstract MP07: Parathyroid Hormone is Associated with Higher Risk of Cardiovascular Diseases: A Systematic Review and Meta-analysis
Introduction Parathyroid hormone (PTH) excess might play a role in cardiovascular health and is associated with cardiovascular disease (CVD) events. We conducted a systematic review to synthesize all available evidence of prospective studies that report the association of PTH in relation to CVD events, and intermediate outcomes in a general population.
Hypothesis We hypothesize that higher PTH concentrations are associated with higher risk of CVD events and unfavorable intermediate outcomes of CVD.
Methods We conducted a comprehensive database search using MEDLINE and Embase between 1947 and January 2012. We included English-language prospective studies that reported risk estimates for PTH and CVD events, and intermediate outcomes. The selection process was performed by 2 authors who independently assessed study quality and extracted characteristics of study popula-tion, exposure and outcome data based on PRISMA Statement and MOOSE guidelines. Results were extracted of the highest vs. lowest PTH category and meta-analyses were carried out using a random effects model.
Results Of 5770 studies identified, 15 studies were included with a study duration between 2 and 14 years, all primarily in Caucasians. Mean age ranged between 55 and 75 years. The meta-analyses included 11 studies, of which 10 for total CVD events, 7 for fatal CVD events and 3 for non-fatal CVD events. PTH excess indicated an increased risk for total CVD events: pooled hazard ratio (HR 95% CI) 1.45 (1.24, 1.71) (Figure 1). The results for fatal and non-fatal CVD events were: HR 1.50 (1.18, 1.91), and HR 1.48 (1.14, 1.92). Heterogeneity was moderately present, however, sensitivity analyses for follow-up duration, prior CVD or PTH as dichotomous values showed similar results.
Conclusion In conclusion, this meta-analysis indicates that higher PTH concentrations are associated with increased risk of CVD events in the general population. Future studies should determine whether a reduction of PTH concentration results in less CVD events.
- © 2013 by American Heart Association, Inc.