Abstract 13334: Phosphorus Level, Renal Dysfunction and Sudden Cardiac Death
Introduction: Chronic renal insufficiency (CRI) is independently associated with inceased risk of sudden cardiac death (SCD) but mechanisms remain unknown. We evaluated a possible role for hyperphosphatemia in CRI patients that suffer SCD, a biochemical abnormality that has been linked to development of left ventricular hypertrophy (LVH).
Hypothesis: Higher phosphorus levels, especially in CRI, are associated with increased SCD risk.
Methods: SCD cases and controls age ≥18 yrs from an ongoing prospective community-based evaluation of SCD in the Northwest US (population approx. 1 million) with phosphorus levels available for review were analyzed. For cases, phosphorus level, and corresponding renal and cardiac function status were evaluated prior and unrelated to the SCD event. Association of phosphorus with SCD in the presence of CRI (CrCl<70 ml/min/1.73m2) and other known risk factors was evaluated using Pearson’s chi-square test and independent sample t-test.
Results: Comparing 324 SCD cases to 239 controls, there were no significant differences in age (66.3 ± 14.9 vs. 67.4 ± 11.6, p=0.6) and gender distribution (male, 69.1 vs. 66.5%, p=0.51). Cases had significantly higher phosphorus level than controls (3.5±1.2 vs. 3.3±0.8, p=0.04), and remained so in subgroups with CRI (3.6 ±1.5 vs. 3.3 ± 0.9, p=0.02), on peritoneal or hemodialysis (4.6 ± 2.0 vs. 2.5 ± 1.1, p=0.05), with CAD (3.6 ± 1.2 vs. 3.3 ± 0.9, p=0.02), and those with both CAD and CRI (3.7 ± 1.5 vs. 3.3 ± 0.9, p=0.01). A similar but non-significant trend was noted in subgroups with LVH (3.6 ± 1.1 vs. 3.3 ± 0.6, p=0.15) and severe LV dysfunction (3.6 ± 1.0 vs. 3.4 ± 1.2, p=0.66).
Conclusions: In this population, high phosphorus levels were associated with SCD even in the presence of known cardiovascular risk factors. A potential mechanistic link between hyperphosphatemia and SCD needs further evaluation, especially in patients with CRI.
Author Disclosures: A. Uy-Evanado: None. C. Teodorescu: None. K. Reinier: None. E. Marijon: None. K. Narayanan: None. H. Chugh: None. K. Gunson: None. J. Jui: None. S.S. Chugh: Employment; Significant; NIH. Research Grant; Significant; NIH. Other; Significant; Boston Scientific and Medtronic.
- © 2014 by American Heart Association, Inc.