Serum intact parathyroid hormone levels predict hospitalisation for heart failure

Objective: To assess whether circulating levels of intact parathyroid hormone (intact PTH) in outpatients predict hospitalisation for heart failure (HF). Methods: Eighty-eight consecutive outpatients with HF were enrolled in the study. The independent association between intact PTH and hospitalisation for HF was assessed using Cox regression analysis. Results: Mean (SD) serum intact PTH levels significantly increased as New York Heart Association classes increased (I: 40 (21), II: 55 (24), III: 76 (46), IV: 131 (45) pg/ml). The receiver operating characteristic (ROC) curves showed intact PTH levels ⩾47 pg/ml to be the optimal cut-off points for hospitalisation for HF, with sensitivity 87%, specificity 71% and area under the ROC curve 0.82 (95% CI 0.72 to 0.91). After adjustment for variables accepted to be predictors for hospitalisation due to HF (age, gender, hypertension, diabetes mellitus, atrial fibrillation, ischaemic heart disease, left ventricular ejection fraction, B-type natriuretic peptide, estimated glomerular filtration rate and cardiac drugs), intact PTH levels ⩾47 pg/ml were associated with a hazard ratio of 7.13 for hospitalisation for HF (95% CI 1.79 to 28.4). Conclusion: Serum intact PTH levels obtained in outpatients with HF were shown to be an independent predictor of hospitalisation for HF.