Serum Parathyroid Hormone Levels Predict Discharge and Readmission for Heart Failure.

Aims: Parathyroid hormone (PTH) levels are useful as a prognostic factor of chronic heart failure (HF) and can predict hospitalization for HF. It is unknown whether serum PTH levels in hospitalized patients with HF can predict discharge and if admission, discharge, or change from admission to discharge PTH measure is the most important predictor of readmission and/or death.

Methods: A total of 125 consecutive hospitalized patients with HF were enrolled into this study. The receiver operating characteristic (ROC) curves indicated the predicted values of PTH for readmission due to HF and the optimal cutoff points of PTH levels for discharge. The binary logistic regression model indicated an association between PTH levels and readmission due to HF.

Results: The PTH level on admission was positively correlated with the New York Heart Association class and N-terminal pro-B-type natriuretic peptide level. The ROC curves showed that the PTH level at discharge (PTHdis) was of predictive value for readmission within 1 year due to HF. A PTHdis level <45.2 pg/mL was the best cutoff point for discharge, with a sensitivity of 72.1%, specificity of 61.5%, and area under the ROC curve of 0.693 (95% confidence interval [CI] 0.598-0.788). The results of logistic regression analysis showed that PTHdis had an odds ratio of 1.035 for readmission due to HF (95% CI 1.005-1.067).

Conclusion: Serum PTH levels in hospitalized patients with HF were shown to be an independent predictor of discharge and PTHdis was the best predictor of readmission and/or death within 1 year due to HF.