Abstract 14499: Serum Parathyroid Hormone is Independently Associated With Atrial Fibrillation: Insights From the LURIC Study
Introduction: Recent evidence from observational studies indicates that in patients with atrial fibrillation (AF) parathyroid hormone (PTH) levels are increased and related to left atrial diameter (LAd). Most studies, however, lack to consider potential confounders. Thus, we aimed to evaluate the circulating PTH concentration in a large cohort of patients with and without AF and its relationship to 1) LAd and 2) the presence of AF under consideration of various confounders.
Methods and Results: 3284 Caucasians (mean age 62.6 +/- 10.6 years, 32% women) from the LUdwigshafen RIsk and Cardiovascular Health (LURIC) study with baseline measurement of PTH were included in the present analysis. ECG and measurement of all baseline parameters were performed on the day of admission to coronary angiography.
AF was detected in 12 % (n=397, 33% women) of the participants. Compared with control subjects, PTH and LAd were significantly higher in probands with AF (PTH: 41 +/- 33 pg/mL vs. 32.9 +/- 27 pg/mL, p<0.001; LAd: 47+/- 8.1 mm vs. 41.5 +/- 6mm, p<0.001). Pearson correlation analysis revealed a stronger relationship between PTH and LAd in patients with (r=0.206; p=0.001) compared to those without AF (r=0.110; p<0.001). In multivariate logistic regression analysis adjusted for cardiovascular risk factors (age, sex, BMI, history of hypertension, type 2 diabetes mellitus, smoking status, pro-brain natriuretic peptide), parameters of calcium metabolism (25-hydroxy-vitamin D, serum calcium, serum phosphate, estimated GFR) and ongoing medication, the third tertile of PTH, comprising PTH levels above 35 pg/mL (mean: 54.2 +/- 41.5 pg/mL), was significantly associated with the presence of AF when compared to the first (OR with 95% CI 1.6 [1.15 - 2.26]; p=0.006).
Conclusion: Our results show, to the best of our knowledge for the first time, that under consideration of multiple confounders PTH is independently associated with the presence of AF. Prospective studies are warranted to further investigate whether elevated PTH levels in the absence of hyperparathyroidism might be a risk factor for the development of AF.
- © 2013 by American Heart Association, Inc.