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The relation between serum phosphorus levels and clinical outcomes after acute myocardial infarction

Doron Aronson1, Michael Kapeliovich, Haim Hammerman

  • 1Department of Cardiology, Rambam Medical Center, Haifa, Israel. daronson@tx.technion.ac.il

Plos One
|March 19, 2013
PubMed

Insights

Elevated serum phosphorus, even within normal ranges, is linked to increased mortality and heart failure risk after acute myocardial infarction (AMI). This association is more pronounced in patients with chronic kidney disease (CKD).

Area of Science:

  • Cardiology
  • Nephrology
  • Biochemistry

Background:

  • Elevated serum phosphorus is controversially linked to cardiovascular disease and mortality, particularly in individuals with normal kidney function.
  • Understanding phosphorus's role in cardiovascular health is crucial for patient outcomes.

Purpose of the Study:

  • To investigate the association between serum phosphorus levels and clinical outcomes in patients following acute myocardial infarction (AMI).
  • To determine if phosphorus levels, even within the normal range, impact mortality and heart failure risk post-AMI.

Main Methods:

  • A cohort of 1663 patients with AMI was analyzed.
  • Patients were stratified into four groups based on serum phosphorus levels (mg/dL): <2.50, 2.51-3.5, 3.51-4.50, and >4.50.
  • Cox proportional-hazards models were employed to assess the relationship between serum phosphorus and outcomes, adjusting for confounders.

Main Results:

  • A graded, independent association was observed between higher serum phosphorus levels and increased all-cause mortality and heart failure risk.
  • The lowest mortality rates were seen in patients with phosphorus levels between 2.5-3.5 mg/dL.
  • The risk of mortality and heart failure was significantly amplified in patients with chronic kidney disease (CKD), especially with phosphorus levels >4.50 mg/dL.

Conclusions:

  • Serum phosphorus levels, even within the normal physiological range, are independently associated with increased all-cause mortality and heart failure post-AMI.
  • The presence of CKD exacerbates the adverse effects of elevated serum phosphorus on mortality risk in AMI patients.
Abstract

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