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Vitamin D status an...
Vitamin D status and outcomes in heart failure patients
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- Liu, Licette C Y (author)
- University of Groningen
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- Voors, Adriaan A (author)
- University of Groningen
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- van Veldhuisen, Dirk J (author)
- University of Groningen
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- van der Veer, Eveline (author)
- University of Groningen
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- Belonje, Anne M (author)
- University of Groningen
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- Szymanski, Mariusz K (author)
- University of Groningen
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- Silljé, Herman H W (author)
- University of Groningen
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- van Gilst, Wiek H (author)
- University of Groningen
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- Jaarsma, Tiny (author)
- Linköpings universitet,Hälsa, Aktivitet, Vård (HAV),Hälsouniversitetet
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- de Boer, Rudolf A (author)
- University of Groningen
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(creator_code:org_t)
- 2014-02-18
- 2011
- English.
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In: European Journal of Heart Failure. - : Wiley. - 1388-9842 .- 1879-0844. ; 13:6, s. 619-625
- Related links:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
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- AIMS: Vitamin D status has been implicated in the pathophysiology of heart failure (HF). The aims of this study were to determine whether a low vitamin D status is associated with prognosis in HF and whether activation of the renin-angiotensin system (RAS) and inflammatory markers could explain this potential association. METHODS AND RESULTS: We measured 25-hydroxy-vitamin D (25(OH)D), plasma renin activity (PRA), interleukin-6 (IL-6), C-reactive protein (CRP), and the incidence of death or HF rehospitalization in 548 patients with HF. Median age was 74 (64-80) years, left ventricular ejection fraction was 30% (23-42), and mean follow-up was 18 months. Low 25(OH)D levels were associated with female gender (P< 0.001), higher age (P= 0.002), and higher N-terminal pro-brain natriuretic peptide (NT-proBNP) levels (P< 0.001). Multivariable linear regression analysis showed that PRA (P= 0.048), and CRP levels (P= 0.006) were independent predictors of 25(OH)D levels. During follow-up, 155 patients died and 142 patients were rehospitalized. Kaplan-Meier analysis showed that lower 25(OH)D concentration was associated with an increased risk for the combined endpoint (all-cause mortality and HF rehospitalization; log rank test P= 0.045) and increased risk for all-cause mortality (log rank test P= 0.014). After adjustment in a multivariable Cox regression analysis, low 25(OH)D concentration remained independently associated with an increased risk for the combined endpoint [hazard ratio (HR) 1.09 per 10 nmol/L decrease; 95% confidence interval (CI) 1.00-1.16; P= 0.040] and all-cause mortality (HR 1.10 per 10 nmol/L decrease; 95% CI 1.00-1.22; P= 0.049). CONCLUSION: A low 25(OH)D concentration is associated with a poor prognosis in HF patients. Activation of the RAS and inflammation may confer the adverse effects of low vitamin D levels.
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Liu, Licette C Y
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Voors, Adriaan A
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van Veldhuisen, ...
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van der Veer, Ev ...
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Belonje, Anne M
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Szymanski, Mariu ...
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show more...
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Silljé, Herman H ...
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van Gilst, Wiek ...
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Jaarsma, Tiny
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de Boer, Rudolf ...
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European Journal ...
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Linköping University