Use of FGF-23 and sαKlotho for Risk Stratification in Patients with Acute Heart Failure

Area of Science:

• Cardiology
• Biomarkers
• Heart Failure Research

Background:

• Soluble αKlotho (sαKlotho) and fibroblast growth factor 23 (FGF-23) are elevated in acute heart failure (AHF).
• Understanding their dynamic changes and prognostic value is crucial for AHF management.

Purpose of the Study:

• To evaluate serum sαKlotho and FGF-23 changes during AHF hospitalization.
• To assess the predictive utility of these biomarkers for long-term AHF prognosis.

Main Methods:

• Prospective study of 104 AHF patients in an intensive cardiac care unit.
• Serum sαKlotho, FGF-23, and NT-proBNP measured at admission and discharge.
• 3-year follow-up for all-cause mortality and HF rehospitalization.

Main Results:

• sαKlotho, FGF-23, and NT-proBNP were significantly higher on admission than discharge (p < 0.001).
• Low admission/discharge sαKlotho levels correlated with a 2-fold increased risk of mortality/rehospitalization (p = 0.006, p = 0.028).
• Increased FGF-23 and sαKlotho during hospitalization elevated mortality/rehospitalization risk (HR 2.75, p = 0.02).

Conclusions:

• sαKlotho and FGF-23 levels are elevated during AHF episodes.
• Low sαKlotho is linked to worse long-term outcomes in AHF.
• Dynamic increases in sαKlotho and FGF-23 during hospitalization identify high-risk AHF patients.