Fibroblast Growth Factor 23 Is an Independent and Specific Predictor of Mortality in Patients With Heart Failure and Reduced Ejection Fraction

BACKGROUND Strategies to improve risk prediction are of major importance in patients with heart failure (HF). Fibroblast growth factor 23 (FGF-23) is an endocrine regulator of phosphate and vitamin D homeostasis associated with an increased cardiovascular risk. We aimed to assess the prognostic effect of FGF-23 on mortality in HF patients with a particular focus on differences between patients with HF with preserved ejection fraction and patients with HF with reduced ejection fraction (HFrEF). METHODS AND RESULTS FGF-23 levels were measured in 980 patients with HF enrolled in the Ludwigshafen Risk and Cardiovascular Health (LURIC) study including 511 patients with HFrEF and 469 patients with HF with preserved ejection fraction and a median follow-up time of 8.6 years. FGF-23 was additionally measured in a second cohort comprising 320 patients with advanced HFrEF. FGF-23 was independently associated with mortality with an adjusted hazard ratio per 1-SD increase of 1.30 (95% confidence interval, 1.14-1.48; P<0.001) in patients with HFrEF, whereas no such association was found in patients with HF with preserved ejection fraction (for interaction, P=0.043). External validation confirmed the significant association with mortality with an adjusted hazard ratio per 1 SD of 1.23 (95% confidence interval, 1.02-1.60; P=0.027). FGF-23 demonstrated an increased discriminatory power for mortality in addition to N-terminal pro-B-type natriuretic peptide (C-statistic: 0.59 versus 0.63) and an improvement in net reclassification index (39.6%; P<0.001). CONCLUSIONS FGF-23 is independently associated with an increased risk of mortality in patients with HFrEF but not in those with HF with preserved ejection fraction, suggesting a different pathophysiologic role for both entities.

Serum amyloid A: high-density lipoproteins interaction and cardiovascular risk.

AIMS High-density lipoproteins (HDLs) are considered as anti-atherogenic. Recent experimental findings suggest that their biological properties can be modified in certain clinical conditions by accumulation of serum amyloid A (SAA). The effect of SAA on the association between HDL-cholesterol (HDL-C) and cardiovascular outcome remains unknown. METHODS AND RESULTS We examined the association of SAA and HDL-C with mortality in the Ludwigshafen Risk and Cardiovascular Health (LURIC) study, which included 3310 patients undergoing coronary angiography. To validate our findings, we analysed 1255 participants of the German Diabetes and Dialysis study (4D) and 4027 participants of the Cooperative Health Research in the Region of Augsburg (KORA) S4 study. In LURIC, SAA concentrations predicted all-cause and cardiovascular mortality. In patients with low SAA, higher HDL-C was associated with lower all-cause and cardiovascular mortality. In contrast, in patients with high SAA, higher HDL-C was associated with increased all-cause and cardiovascular mortality, indicating that SAA indeed modifies the beneficial properties of HDL. We complemented these clinical observations by in vitro experiments, in which SAA impaired vascular functions of HDL. We further derived a formula for the simple calculation of the amount of biologically 'effective' HDL-C based on measured HDL-C and SAA from the LURIC study. In 4D and KORA S4 studies, we found that measured HDL-C was not associated with clinical outcomes, whereas calculated 'effective' HDL-C significantly predicted better outcome. CONCLUSION The acute-phase protein SAA modifies the biological effects of HDL-C in several clinical conditions. The concomitant measurement of SAA is a simple, useful, and clinically applicable surrogate for the vascular functionality of HDL.

Die wirtschaftliche Haltung des Milchviehs : unter besonderer Berücksichtigung der Konstitutionsstärkung

Hubert Auhagen

Jüdische Kolonisation in Syrien

Hubert Auhagen

Gubert v strane čudes : dela i dni nemeckogo pionera

Über die Reise des Paradejungpioniers Hubert L'Hoste vom Saargebiet, quer durch Europa nach Russland. Mit einem Würfel-Spielplan, der diese Reise nachstellt

Ms. Barth. 39 - Scriptum super quartum Sententiarum

Vorbesitzer: Bartholomaeusstift Frankfurt am Main

Na 1 Nachlass Max Horkheimer, 1 - Korrespondenzen u.a. mit Franz Alexander (p. I 1, 1-205)

1 Brief von Max Horkheimer an Abel, 16.03.1936; 3 Briefe zwischen Hubert Abrahamsohn und Max Horkheimer, 1935-1936, 21.12.1936; 2 Briefe zwischen Emanuel Adler und Max Horkheimer, 12.04.1946, 26.04.1946; 2 Briefe zwischen Max Adler und Max Horkheimer, 16.03.1935, 29.03.1935; 1 Brief von Eva Ahamson an Max Horkheimer, 01.11.1944; 2 Briefe der Aircraft Warning Service Brentwood an Max Horkheimer, Mai 1942; 6 Briefe zwischen Librairie Félix Alcan und Max Horkheimer, 1935, 18.12.1935; 11 Briefe zwischen Franz Alexander und Max Horkheimer, 1938-1940; 2 Briefe zwischen der American Historical Review New York und Max Horkheimer, 01.04.1941, 07.04.1941; 1 Brief von Paul Reiwald an Max Horkheimer, 18.10.1940; 2 Briefe zwischen Helen Manice Alexander und Max Horkheimer, 1936; 2 Briefe zwischen Bernardine Allen und Max Horkheimer, 17.06.1938, 24.06.1938; 1 Brief der Alumni Federation of Columbia University an Max Horkheimer, 21.07.1942; 1 Brief der American Friends Service Comittee an Max Horkheimer, 10.12.1940; 3 Briefe zwischen der American Academy of Political and Social Science Philadelphia und Max Horkheimer, 1939,1940, 16.01.1939; 1 Brief der American Automobile Association Washington an Max Horkheimer, 22.03.1938; 1 Brief der American Association for the Advancement of Science Washington an Max Horkheimer, 16.08.1937; 2 Briefe von Max Horkheimer an den American Consulate General Berlin, 1939; 1 Brief von Max Horkheimer an den American Consulate General Havana, 03.03.1941; 4 Briefe von Max Horkheimer an den American Consul London, 1939-1941; 2 Briefe von Max Horkheimer an den American Consulate General Stuttgart, 1939-1941; 1 Brief von Max Horkheimer an den American Consul Zürich, 1939; 1 Brief von Friedrich Pollock an den American Council of Learned Society, Washington, 27.06.1941; 2 Briefe von Max Horkheimer an die American Friends of German Freedom New York, 1941; 4 Briefe der American Historical Association Washington an Max Horkheimer, 1937-1938; 1 Brief von Max Horkheimer an den American Red Cross Westwood Office, 21.06.1943; 18 Briefe zwschen der American Society for the Prevention of Cruelty to Animals New York und Max Horkheimer, 1936-1941; 1 Brief von Max Horkheimer an die American Women's Volunteer Service Pacific Palisades, 27.07.1942; 23 Briefe zwischen Eugene Anderson und Max Horkheimer, 1937-1941; 2 Briefe zwischen Norah Andreae und Max Horkheimer, 27.10.1944, 09.09.1946; 1 Brief von Rosa Nebel-Schenk, 04.03.1946; 1 Brief von der National Catholic Welfare Conference, 14.08.1944; 12 Briefe zwischen Werner Andreae und Max Horkheimer, 1945-1954; 1 Brief von Julius Marx an Werner Andreae, 10.05.1946, 11.05.1950; 2 Briefe von Josef Messinger an Werner Andreae, 23.10.1946, ohne Datum; 3 Briefe zwischen dem Advokatenbüro Hodler und Max Horkheimer, 1946, 09.05.1946;

Krystalloide in Zellkernen

von H. Leitgeb

Beiträge zur Physiologie der Spaltöffnungsapparate

von H. Leitgeb

Der Gehalt der Dahliaknollen an Asparagin und Tyrosin

von H. Leitgeb

Ueber Sphärite

von H. Leitgeb

Das israelitische Pfingstfest und der Plejadenkult : eine Studie

von Hubert Grimme

Ms. Praed. 66 - Scriptum super quartum Sententiarum

Vorbesitzer: Dominikanerkloster Frankfurt am Main

Ms. Praed. 114 - Excerptum e Thomae de Aquino Summae theologiae parte prima

Vorbesitzer: Dominikanerkloster Frankfurt am Main

Entstehung und Wachsthum der Wurzeln

Von C. Nägeli und H. Leitgeb