Klotho plasma levels are an independent predictorof mortality in women with acute coronary syndrome

Abstract Alterations in plasma levels of the components of the mineral metabolism (MM) system are related to cardiovascular diseases. However, gender differences of the whole MM system in patients with acute coronary syndrome (ACS) have not been reported. Our objective was to analyse the potential d...

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Main Authors: Marcelino Cortés, Andrea Kallmeyer, Nieves Tarín, Carmen Cristóbal, Ana María Pello, Alvaro Aceña, Carlos Gutiérrez-Landaluce, Ana Huelmos, Joaquín Alonso, Lorenzo López-Bescós, Ignacio Mahíllo-Fernández, Óscar Lorenzo, María Luisa González-Casaus, Jesús Egido, José Tuñón
Format: Article
Language:English
Published: Nature Portfolio 2025-05-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-01334-2
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author Marcelino Cortés
Andrea Kallmeyer
Nieves Tarín
Carmen Cristóbal
Ana María Pello
Alvaro Aceña
Carlos Gutiérrez-Landaluce
Ana Huelmos
Joaquín Alonso
Lorenzo López-Bescós
Ignacio Mahíllo-Fernández
Óscar Lorenzo
María Luisa González-Casaus
Jesús Egido
José Tuñón
author_facet Marcelino Cortés
Andrea Kallmeyer
Nieves Tarín
Carmen Cristóbal
Ana María Pello
Alvaro Aceña
Carlos Gutiérrez-Landaluce
Ana Huelmos
Joaquín Alonso
Lorenzo López-Bescós
Ignacio Mahíllo-Fernández
Óscar Lorenzo
María Luisa González-Casaus
Jesús Egido
José Tuñón
author_sort Marcelino Cortés
collection DOAJ
description Abstract Alterations in plasma levels of the components of the mineral metabolism (MM) system are related to cardiovascular diseases. However, gender differences of the whole MM system in patients with acute coronary syndrome (ACS) have not been reported. Our objective was to analyse the potential differences on the prognostic role of MM in women suffering an ACS as compared to men. We included 1,230 patients with ACS and collected clinical data and plasma levels of MM components. Primary outcome was a composite of acute ischaemic events, heart failure and all-cause mortality. Secondary outcomes included each component separately. 282 patients (22.9%) were female. After 5.44 years of follow-up, primary outcome occurred in 28.0% women and 23.5% men, and death in 10.6% and 9.4% respectively. FGF23 was associated with primary outcome in both sexes, and calcidiol only in men (HR 1.04, CI95%1.00-1.03). Klotho levels are inversely related to all-cause mortality only in women (HR 0.80, CI95% 0.67–0.96), while calcidiol (HR 0.84, CI95%0.72–0.98) and FGF23 levels (HR 1.02 CI95%1.00-1.03) were predictors in men, highlighting a possible gender-specific prognostic biomarker. These results underline the importance of considering MM biomarkers in risk stratification and management of patients with acute coronary syndromes, with attention to gender differences.
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spelling doaj-art-ace6a7e260594c8180683db16e1f61d42025-08-20T03:53:46ZengNature PortfolioScientific Reports2045-23222025-05-0115111010.1038/s41598-025-01334-2Klotho plasma levels are an independent predictorof mortality in women with acute coronary syndromeMarcelino Cortés0Andrea Kallmeyer1Nieves Tarín2Carmen Cristóbal3Ana María Pello4Alvaro Aceña5Carlos Gutiérrez-Landaluce6Ana Huelmos7Joaquín Alonso8Lorenzo López-Bescós9Ignacio Mahíllo-Fernández10Óscar Lorenzo11María Luisa González-Casaus12Jesús Egido13José Tuñón14Department of Cardiology, Fundación Jiménez DíazDepartment of Cardiology, Fundación Jiménez DíazDepartment of Cardiology, Hospital Universitario de MóstolesFaculty of Medicine, Universidad Rey Juan CarlosDepartment of Cardiology, Fundación Jiménez DíazDepartment of Cardiology, Fundación Jiménez DíazDepartment of Cardiology, Hospital Universitario de FuenlabradaDepartment of Cardiology, Hospital Universitario Fundación AlcorcónFaculty of Medicine, Universidad Rey Juan CarlosFaculty of Medicine, Universidad Rey Juan CarlosDepartment of Epidemiology and Biostatistics Research Unit, IIS-Fundación Jiménez DíazDepartment of Medicine, Faculty of Medicine, Universidad Autónoma de MadridDepartment of Laboratory Medicine, La Paz University HospitalDepartment of Medicine, Faculty of Medicine, Universidad Autónoma de MadridDepartment of Cardiology, Fundación Jiménez DíazAbstract Alterations in plasma levels of the components of the mineral metabolism (MM) system are related to cardiovascular diseases. However, gender differences of the whole MM system in patients with acute coronary syndrome (ACS) have not been reported. Our objective was to analyse the potential differences on the prognostic role of MM in women suffering an ACS as compared to men. We included 1,230 patients with ACS and collected clinical data and plasma levels of MM components. Primary outcome was a composite of acute ischaemic events, heart failure and all-cause mortality. Secondary outcomes included each component separately. 282 patients (22.9%) were female. After 5.44 years of follow-up, primary outcome occurred in 28.0% women and 23.5% men, and death in 10.6% and 9.4% respectively. FGF23 was associated with primary outcome in both sexes, and calcidiol only in men (HR 1.04, CI95%1.00-1.03). Klotho levels are inversely related to all-cause mortality only in women (HR 0.80, CI95% 0.67–0.96), while calcidiol (HR 0.84, CI95%0.72–0.98) and FGF23 levels (HR 1.02 CI95%1.00-1.03) were predictors in men, highlighting a possible gender-specific prognostic biomarker. These results underline the importance of considering MM biomarkers in risk stratification and management of patients with acute coronary syndromes, with attention to gender differences.https://doi.org/10.1038/s41598-025-01334-2Klotho proteinGenderAcute coronary syndromeMineral metabolismCardiovascular risk
spellingShingle Marcelino Cortés
Andrea Kallmeyer
Nieves Tarín
Carmen Cristóbal
Ana María Pello
Alvaro Aceña
Carlos Gutiérrez-Landaluce
Ana Huelmos
Joaquín Alonso
Lorenzo López-Bescós
Ignacio Mahíllo-Fernández
Óscar Lorenzo
María Luisa González-Casaus
Jesús Egido
José Tuñón
Klotho plasma levels are an independent predictorof mortality in women with acute coronary syndrome
Scientific Reports
Klotho protein
Gender
Acute coronary syndrome
Mineral metabolism
Cardiovascular risk
title Klotho plasma levels are an independent predictorof mortality in women with acute coronary syndrome
title_full Klotho plasma levels are an independent predictorof mortality in women with acute coronary syndrome
title_fullStr Klotho plasma levels are an independent predictorof mortality in women with acute coronary syndrome
title_full_unstemmed Klotho plasma levels are an independent predictorof mortality in women with acute coronary syndrome
title_short Klotho plasma levels are an independent predictorof mortality in women with acute coronary syndrome
title_sort klotho plasma levels are an independent predictorof mortality in women with acute coronary syndrome
topic Klotho protein
Gender
Acute coronary syndrome
Mineral metabolism
Cardiovascular risk
url https://doi.org/10.1038/s41598-025-01334-2
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