Cardiac Rehabilitation Increases Plasma Klotho Levels

• Published in: Journal of clinical medicine Vol. 13; no. 6; p. 1664
• Main Authors: Pello Lázaro, Ana María, Villelabeitia Jaureguizar, Koldo, Franco Peláez, Juan Antonio, Venegas-Rodriguez, Ana, Aceña, Álvaro, Kallmeyer, Andrea, Cánovas, Ester, González-Casaus, María Luisa, Tarín, Nieves, Cristóbal, Carmen, Gutiérrez-Landaluce, Carlos, Huelmos, Ana, González-Lorenzo, Óscar, Alonso, Joaquín, López-Bescós, Lorenzo, Egido, Jesús, Mahillo-Fernández, Ignacio, Lumpuy-Castillo, Jairo, Lorenzo, Óscar, Tuñón, José
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 14.03.2024; MDPI
• Subjects: Acute coronary syndromes; Angina pectoris; Biomarkers; Blood plasma; Coronary artery bypass; Coronary heart disease; Diabetes therapy; Disease; Electrocardiography; Enzyme inhibitors; Ethylenediaminetetraacetic acid; Evidence-based medicine; Fibroblast growth factors; Health aspects; Heart attacks; Hemoglobin; Hypertension; Immunoassay; Laboratories; Medical research; Medicine, Experimental; Membrane proteins; Mortality; Oxidative stress; Physiological aspects; Plasma; Regression analysis; Rehabilitation; Risk factors; Variables; Germany; Spain; United States > US; Madrid Spain; fibroblast growth factor-23; klotho; acute coronary syndrome; mineral metabolism biomarkers; cardiovascular risk
• ISSN: 2077-0383; 2077-0383
• DOI: 10.3390/jcm13061664

: Mineral metabolism (MM), mainly fibroblast growth factor-23 (FGF-23) and klotho, has been linked to cardiovascular (CV) diseases. Cardiac rehabilitation (CR) has been demonstrated to reduce CV events, although its potential relationship with changes in MM is unknown. : We performed a prospective, observational, case-control study, with acute coronary syndrome (ACS) patients who underwent CR and control patients (matched by age, gender, left ventricular ejection fraction, diabetes, and coronary artery bypass grafting), who did not. The inclusion dates were from August 2013 to November 2017 in CR group and from July 2006 to June 2014 in control group. Clinical, biochemical, and MM biomarkers were collected at discharge and six months later. Our objective was to evaluate differences in the modification pattern of MM in both groups. : We included 58 CR patients and 116 controls. The control group showed a higher prevalence of hypertension (50.9% vs. 34.5%), ST-elevated myocardial infarction (59.5% vs. 29.3%), and treatment with angiotensin-converting enzyme inhibitors (100% vs. 69%). P2Y12 inhibitors and beta-blockers were more frequently prescribed in the CR group (83.6% vs. 96.6% and 82.8% vs. 94.8%, respectively). After six months, klotho levels increased in CR patients whereas they were reduced in controls (+63 vs. -49 pg/mL; < 0.001). FGF-23 was unchanged in the CR group and reduced in controls (+0.2 vs. -17.3 RU/dL; < 0.003). After multivariate analysis, only the change in klotho levels was significantly different between groups (+124 pg/mL favoring CR group; IC 95% [+44 to +205]; = 0.003). : In our study, CR after ACS increases plasma klotho levels without significant changes in other components of MM. Further studies are needed to clarify whether this effect has a causal role in the clinical benefit of CR.