Abstract 9958: Calcium-Phosphorus Product is Associated with Adverse Prognosis in Hospitalized Patients with Heart Failure and Chronic Kidney Disease

Abstract

Introduction: It has been reported that calcium-phosphorus (Ca-P) product &gt 55 mg 2 /dl 2 is an independent predictor for coronary calcifications, and Ca-P product &gt 80 or &lt 40 is a mortality risk in patients undergoing chronic hemodialysis. However, the association between Ca-P product and prognosis in patients with heart failure (HF) and chronic kidney disease (CKD) remains unclear. We aimed to evaluate the significance of the Ca-P product to predict prognosis of patients with HF and CKD. Methods: We conducted a prospective observational study of 793 patients with decompensated HF and CKD, who had been discharged from our hospital. According to the receiver operating characteristic curve analysis, the accurate cut-off value of Ca-P product in predicting post-discharge all-cause mortality and/or worsening HF was 28 mg 2 /dl 2 . These patients were divided into two groups: the high group (Ca-P product &gt 28, n=594) and the low group (Ca-P product &lt 28, n=199). We compared the patient baseline characteristics and their post-discharge prognosis between the two groups. Results: Age was significantly higher, and the prevalence of male, ischemic etiology and anemia was significantly higher in the low group than in the high group. In contrast, there was no difference in echocardiographic parameters between two groups. Ca-P product was correlated with cardio-ankle vascular index (a marker of arterial stiffness), but not with left ventricular ejection fraction. In the Kaplan-Meier analysis (mean follow-up 1089 days), all-cause mortality and/or worsening HF event rates were higher in the low group than in the high group (Figure, log-rank P=0.001). In the multivariable Cox proportional hazard analysis, the low group was found to be an independent predictor of all-cause mortality and/or worsening HF (hazard ratio 1.218, P=0.048). Conclusions: Lower Ca-P product is associated with arterial stiffness, and predicts adverse prognosis in patients with HF and CKD.