Association between phosphate and long-term outcome in CAD patients underwent coronary intervention

Area of Science:

• Cardiology
• Nephrology
• Biochemistry

Background:

• Phosphate is increasingly recognized as a risk factor for cardiovascular disease (CVD).
• The specific impact of phosphate levels on outcomes for patients with coronary artery disease (CAD) following percutaneous coronary interventions (PCI) remains unclear.

Purpose of the Study:

• To investigate the association between serum phosphate levels and adverse cardiovascular outcomes in patients with CAD who have undergone PCI.
• To identify a potential optimal phosphate range for reducing cardiovascular risk in this patient population.

Main Methods:

• A retrospective analysis of 2,894 CAD patients who underwent PCI between 2006 and 2015.
• Phosphate levels were measured, and patients were followed for major adverse cardiovascular events (MACE) and heart failure hospitalizations (HHF).
• Cox proportional hazards models were used to assess the association between phosphate levels and outcomes, adjusting for comorbidities and renal function.

Main Results:

• A J-curve association was observed between phosphate levels and cardiovascular events, with the lowest risk around 3.2 ± 0.1 mg/dL.
• Each 1 mg/dL increase in phosphate was associated with a higher risk of MACE + HHF (HR: 1.12), CV death (HR: 1.37), and HHF (HR: 1.12).
• Subgroup analyses revealed a more pronounced association in males, older patients (>65 years), those with bare-metal stents, reduced ejection fraction (<50%), lower eGFR (<60), higher LDL (>70 mg/dL), and emergent PCI.

Conclusions:

• Serum phosphate levels are significantly associated with adverse cardiovascular outcomes in CAD patients undergoing PCI.
• This association is independent of traditional comorbidities and renal function.
• Maintaining phosphate levels within a specific range may be crucial for improving cardiovascular outcomes in patients post-PCI.