Participation of fibroblast factor 23 in the development of acute myocardial infarction in patients with chronic kidney disease

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Abstract

Objective. Evaluation of the participation of fibroblast growth factor 23 (FGF-23) in relation to mineral metabolism indicators in the development of acute myocardial infarction (AMI) in patients with chronic kidney disease (CKD) receiving renal replacement therapy; assessment of the risk of fatal and non-fatal cases .

Material and methods. A prospective cohort study of 85 patients with stage 5D CKD on program hemodialysis was conducted over a period of 3 years. At the first stage of the study, indicators characterizing mineral and bone disorders such as blood phosphate, calcium, parathyroid hormone (PTH), calcitriol (1,25(OH)D), fibroblast growth factor 23 (FGF-23) and transmembrane protein Alpha- Clotho (A-Klotho) levels were determined. The second stage of the study was carried out 3.1±0.1 years after with the registration of cases of fatal and non-fatal AMI.

Results. 10 cases of AMI were registered: 6 non-fatal and 4 fatal cases. It was found that high FGF-23 and low A-Klotho levels do not have independent risk activity against AMI (P>0.05). Analysis of the combined effect of high FGF-23 and/or low A-Klotho levels with hyperphosphatemia and 1,25(OH)D3 deficiency demonstrates a significantly significant increase in the risk of developing all cases of AMI (P<0.05); a relationship with 1,25(OH)D3 deficiency in cases of fatal and non-fatal AMI (P<0.05) was shown. A statistically significant effect of an isolated 1,25(OH)D3 deficiency, a concomitant effect of several factors (hyperphosphatemia, hyperparathyroidism, vitamin D deficiency) on the risk of AMI was established.

Conclusion. FGF-23 is one of the key markers for the development of both fatal and non-fatal cases of AMI, predicting cardiovascular risk in CKD patients. Data on the concomitant influence of several factors among mineral-bone disorders on the risk of AMI are noteworthy.

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About the authors

Aneta M. Mambetova

Kh.M. Berbekov Kabardino-Balkarian State University

Author for correspondence.
Email: amm-0007@yandex.ru
ORCID iD: 0000-0003-0378-0754

Dr. Sci. (Med.), Professor at the Department of General Medical Training and Medical Rehabilitation

Russian Federation, Nalchik

Shamsiya N. Gaturaeva

Republican Clinical Hospital n.a. Sh.Sh. Ependiev, Ministry of Health of the Chechen Republic

Email: nefrolog_00@mail.ru
ORCID iD: 0000-0003-4309-5487

Head of the Department of Efferent Blood Surgery and Hemodialysis

Russian Federation, Grozny

Irina L. Semenova

Kh.M. Berbekov Kabardino-Balkarian State University

Email: jaec@yandex.ru
ORCID iD: 0000-0002-2658-6551

Senior Lecturer, Department of General Medical Training and Medical Rehabilitation, Faculty of General Medicine

Russian Federation, Nalchik

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