Table 2.
Associations of FGF‐23 and Incident HF, HFrEF, and HFpEF (HRs for Each 20 pg/mL Higher FGF‐23 Concentration and Per Quartiles of FGF‐23): The Multiethnic Study of Atherosclerosis
| Participants (n) | Events (n) | Model 1 | Model 2 | Model 3 | Model 4 | |
|---|---|---|---|---|---|---|
| HR (95% CI) | HR (95% CI) | HR (95% CI) | HR (95% CI) | |||
| Incident HF | ||||||
| FGF‐23 | ||||||
| per 20 pg/L increase | 6542 | 291 | 1.34 (1.21, 1.48) | 1.20 (1.08, 1.35) | 1.17 (1.04, 1.32) | 1.18 (1.02, 1.37) |
| Q1 | 1638 | 45 | 1.00 (Reference) | 1.00 (Reference) | 1.00 (Reference) | 1.00 (Reference) |
| Q2 | 1636 | 62 | 1.30 (0.84, 2.01) | 1.14 (0.74, 1.77) | 1.18 (0.76, 1.83) | 1.17 (0.75, 1.80) |
| Q3 | 1634 | 81 | 1.67 (1.11, 2.52) | 1.34 (0.88, 2.03) | 1.45 (0.95, 2.21) | 1.37 (0.90, 2.08) |
| Q4 | 1634 | 103 | 2.44 (1.66, 3.61) | 1.72 (1.15, 2.56) | 1.68 (1.11, 2.54) | 1.51 (1.00, 2.30) |
| Incident HFrEF | ||||||
| FGF‐23 | ||||||
| per 20 pg/L increase | 6542 | 176 | 1.33 (1.13, 1.56) | 1.25 (1.04, 1.51) | 1.13 (0.93, 1.37) | 1.04 (0.84, 1.29) |
| Q1 | 1638 | 27 | 1.00 (Reference) | 1.00 (Reference) | 1.00 (Reference) | 1.00 (Reference) |
| Q2 | 1636 | 40 | 1.40 (0.81, 2.42) | 1.26 (0.73, 2.18) | 1.32 (0.76, 2.30) | 1.29 (0.75, 2.24) |
| Q3 | 1634 | 51 | 1.56 (0.92, 2.66) | 1.31 (0.76, 2.24) | 1.40 (0.81, 2.42) | 1.26 (0.73, 2.17) |
| Q4 | 1634 | 58 | 2.22 (1.34, 3.67) | 1.65 (0.98, 2.77) | 1.50 (0.88, 2.57) | 1.25 (0.72, 2.17) |
| Incident HFpEF | ||||||
| FGF‐23 | ||||||
| per 20 pg/L increase | 6542 | 149 | 1.48 (1.28, 1.70) | 1.36 (1.15, 1.61) | 1.31 (1.11, 1.55) | 1.29 (1.08, 1.54) |
| Q1 | 1638 | 23 | 1.00 (Reference) | 1.00 (Reference) | 1.00 (Reference) | 1.00 (Reference) |
| Q2 | 1636 | 27 | 1.17 (0.61, 2.24) | 1.01 (0.53, 1.94) | 1.06 (0.55, 2.04) | 1.05 (0.55, 2.02) |
| Q3 | 1634 | 40 | 1.90 (1.06, 3.41) | 1.46 (0.81, 2.64) | 1.59 (0.87, 2.89) | 1.51 (0.83, 2.75) |
| Q4 | 1634 | 59 | 3.00 (1.73, 5.21) | 1.96 (1.12, 3.44) | 1.99 (1.11, 3.57) | 1.85 (1.03, 3.33) |
Cox proportional models were used to calculate the HRs for the development of incident HF, HFrEF, and HFpEF with each 20 pg/mL higher serum FGF‐23 concentration and again with quartiles of FGF‐23. Model 1; unadjusted, Model 2; adjusted for age, sex, race/ethnicity, education, study site, height, and weight; Model 3 adjusted for Model 2 and systolic blood pressure, antihypertensive medications, diabetes mellitus, smoking, C‐reactive protein, urine albumin–creatinine ratio, and eGFRCKD‐EPI. Model 4 is further adjusted for NT‐proBNP, 25(OH) vitamin D, PTH, and phosphate. CI indicates confidence interval; eGFR, glomerular filtration rate; FGF‐23, fibroblast growth factor‐23; HF, heart failure; HFpEF, heart failure with preserved ejection fraction; HFrEF, heart failure with reduced ejection fraction; HR, hazard ratio; NT‐proBNP, N‐terminal pro‐B‐type natriuretic peptide; PTH, parathyroid hormone.