Abstract 15008: Bone Marrow Plasma Fibroblast Growth Factor 23 Levels Are a Strong Predictor of Death in Patients With Chronic Heart Failure
Introduction and Aim: Fibroblast growth factor 23 (FGF-23) is primarily known as a regulator in phosphate and calcium homeostasis. It has been described that FGF-23 might play a role in cardiovascular disease: peripheral FGF-23 levels are associated with left ventricular hypertrophy, coronary artery disease and chronic heart failure (CHF). Aim of the present study was to evaluate the prognostic information of FGF-23 measured in bone marrow plasma (FGFBM-23) as well as in peripheral blood samples (FGFPB-23) of patients with CHF.
Methods: In 237 patients (age 61.4±12.2) with CHF, who were enrolled in the Frankfurt Bone Marrow-Derived Cell Therapy Registry, and in 49 healthy control individuals (age 39.1±10.8), FGFPB-23 and FGFBM-23 levels were measured. Within a 5-year-follow up period, out of the 237 patients with CHF, 54 patients (23%) died, used as outcome measure.
Results: Both, FGFBM-23 and FGFPB-23 were significantly increased in CHF patients compared to healthy individuals (p<0.001) In general, FGFBM-23 levels were higher than FGFPB-23 levels. Furthermore, in patients who died within 5 years, FGFBM-23 as well as FGFPB-23 was increased compared to survivors (p<0.001). FGFBM-23 as well as FGFPB-23 at baseline did correlate with ejection fraction (EF), estimated glomerular filtration rate (eGFR) and age (all p<0.001), but not with gender. In cox regression analyses, FGFPB-23 and FGFBM-23 were strongly associated with death with hazard ration (HR) of 1.41 (1.214, 1.638; p<0.001) and 1.422 (1.222, 1.654; p<0.001), respectively. After adjustment for the Seattle heart failure model score, FGFPB-23 and FGFBM-23 remained significant independent indicators for death with HR of 1.352 (1.14, 1.603; p<0.001) and HR of 1.267 (1.067, 1.506; p=0.007).
Conclusion: In patients with chronic heart failure, elevated FGF-23 measured in bone marrow plasma and in peripheral blood is strongly associated with long-term mortality. These findings underline the importance of the heart-bone axis in heart failure development and Progression.
Author Disclosures: B. von Jeinsen: None. K. Sopova: None. L. Palapies: None. S. Fichtlscherer: None. F. Seeger: None. S. Dimmeler: None. B. Assmus: None. A.M. Zeiher: None. T. Keller: None.
- © 2016 by American Heart Association, Inc.