Issue: Vojnosanit Pregl 2017; Vol. 74 (No. 3)
Prognostic value of serum parathyroid hormone in ST-elevation myocardial infarction patients
Authors:
Slobodan Obradović, Snježana Vukotić, Marko Banović, Boris Džudović, Jelena Marinković, Svetlana Vujanić, Dragana ObradovićSlobodan Obradović, Snježana Vukotić, Marko Banović, Boris Džudović, Jelena Marinković, Svetlana Vujanić, Dragana Obradović
Background/Aim. Parathyroid hormone (PTH) is an importantmessenger in the regeneration process which might
influence the outcome of patients with ST-segment elevation
myocardial infarction (STEMI). The aim of this study was to
investigate the role of PTH in comparison to other traditionally
used markers for the prediction of heart failure in STEMI
patients. Methods. In 165 consecutive patients with STEMI
treated with primary percutaneous coronary intervention
(PCI), blood concentrations of PTH, C-reactive protein
(CRP), B-type natriuretic peptide (BNP), creatine kinase MB
(CK-MB) and admission glycaemia (AG) were measured during
the first three days after admission and correlated to the
primary outcome – episodes of acute heart failure in the period
of six months. Results. The area under the ROC curve
of the maximal serum concentration of PTH was the largest
among the measured biomarkers (0.867 vs 0.835 vs 0.832 vs
0.627 vs 0.619, for PTH, CRP, BNP, CK-MB and AG, respectively)
for the prediction of primary outcome. The
maximal PTH level adjusted to several risk factors had an independent
prediction value for primary outcome (p < 0.001).
In addition, PTH improved the prediction of primary outcome
when added to the other markers in the model [cstatistic
with BNP, CRP, CK-MB and AG was 0.908 (95% CI
0.849–0.967)], and when PTH was added, it was 0.931
(0.883–0.980), with p < 0.001 for the discrimination. Conclusion.
Serum concentration of PTH early in the course of
STEMI can predict acute heart failure episodes in the first six
months in patients treated with primary PCI.
