Higher Serum Phosphorus Is Not an Independent Risk Factor of Mortality in Heart Failure with Reduced Ejection Fraction.

Higher serum phosphorus has detrimental health effects. Even high-normal rage sP is associated with worse outcomes. The relationship of serum phosphorus with prognostic markers in heart failure remains unclear. We investigated the association of serum phosphorus with heart failure prognostic factors and risk of mortality related to serum phosphorus. In 1029 stable heart failure patients, we investigated the distribution of markers of more advanced heart failure stage across quintiles of serum phosphorus and estimated the relative risk of mortality in comparison to reference. Higher serum phosphorus levels sP were associated with markers of a worse outcome. The best survival was observed in low-normal serum levels. The unadjusted hazard ratio for mortality increased toward higher phosphorus quintiles but not to lower levels of sP. The correction for age, sex, BMI, percent weight loss, inflammation, kidney function, and LVEF did not modify the risk profile substantially. The adjustment for NYHA, natriuretic peptides, serum sodium, and treatment characteristics broke down the risk relationship completely. A higher serum phosphorus is associated with markers of a more risky profile of heart failure. Elevated serum levels of phosphorus sP does not provide independent prognostic information beyond the strongest markers of the severity of the syndrome. The potential involvement of higher serum phosphorus as a mediator in the pathophysiology of heart failure warrants further study.

[Effect of cigarette smoking on exhaled nitric oxide levels in healthy volunteers and patients with coronary heart disease]. / Wplyw palenia tytoniu na stezenia wydychanego tlenku azotu u zdrowych ochotników i pacjentów z choroba wiencowa.

UNLABELLED: Exhaled air contains nitric oxide in very low concentrations reaching several parts per billion. There are many factors which can influence exhaled nitric oxide levels (eNO), one of them is cigarette smoking. MATERIAL AND METHODS: We investigated 78 patients: Group I (n = 26)--smokers, divided in two subgroups--I A healthy volunteers (n = 13) and I B--patients with coronary heart disease (CAD) (n = 13) Group II (n = 52)--nonsmokers. They were also divided in two subgroups--II A healthy volunteers (n = 21) and II B patients with CAD taking nitrates orally (n = 31) We use NO analyzer NOA 280 (Sievers Boulder Col. USA) with chemo-luminescence method RESULTS: We found that eNO levels were significantly lower in smoking group than in nonsmokers. This fact was noticed in whole investigated population and in both subgroups, CONCLUSION: 1. Cigarette smoking significantly lowers exhaled nitric oxide levels and should be always taken into account during interpretation of the results. 2. Cigarette smoking significantly lowers exhaled nitric oxide levels even with of oral nitrates therapy.