{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T23:57:49Z","timestamp":1792799869410,"version":"4.5.0"},"reference-count":64,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,2,17]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Elevation of FGF23 (fibroblast growth factor 23) and decreased Klotho levels have been associated with various cardiovascular and renal diseases. However, the combined study of the FGF23\u2013Klotho axis in ischemic heart disease remains elusive.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">We analyzed the associations between circulating FGF23 and Klotho levels with cardiac and renal parameters, as well as mortality outcomes following myocardial infarction (MI). Cardiac tissue from patients with ischemic heart disease and a post\u2010MI mouse model were analyzed to assess myocardial FGF23 expression. Proteomic analysis was performed to examine myocardial pathways activated by FGF23 and regulated by Klotho.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">We observed an inverse correlation between circulating levels of FGF23 and Klotho in patients after MI. Elevated plasma FGF23 levels were particularly associated with ST\u2010segment\u2013elevation MI and cardiac dysfunction, including reduced left ventricular ejection fraction, prolonged corrected interval, and higher Killip\u2013Kimball classification of cardiac risk, identifying FGF23 as a potential prognostic marker of overall and cardiac\u2010related mortality. In contrast, systemic Klotho levels were reduced in patients with ST\u2010segment\u2013elevation MI but did not correlate with mortality. In cardiac tissue, ischemic injury significantly upregulated FGF23 expression. Although Klotho prevented FGF23\u2010induced proteomic alterations, it did not inhibit cardiac FGF23 overexpression in the post\u2010MI model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">FGF23 represents a promising biomarker for mortality and cardiac dysfunction in patients with MI. Although Klotho does not appear to be a reliable predictor of mortality after MI, its cardioprotective properties suggest a role in modulating FGF23\u2010driven metabolic, structural, and proliferative processes in the myocardium.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.045175","type":"journal-article","created":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T11:25:53Z","timestamp":1770895553000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Fibroblast Growth Factor 23 as a Prognostic Biomarker in Post\u2010Myocardial Infarction Outcomes: Influence of Renal Function and Its Modulation by Klotho"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8082-9745","authenticated-orcid":false,"given":"Sara","family":"V\u00e1zquez\u2010S\u00e1nchez","sequence":"first","affiliation":[{"name":"Hospital Universitario 12 de Octubre","place":["Madrid, Spain"]},{"name":"RICORS2040\u2010Renal, ISCIII","place":["Madrid, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9067-6773","authenticated-orcid":false,"given":"Ana","family":"Blasco","sequence":"additional","affiliation":[{"name":"Hospital Universitario Puerta de Hierro\u2010Majadahonda","place":["Madrid, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-9197-5010","authenticated-orcid":false,"given":"Marina","family":"Polo\u2010Salguero","sequence":"additional","affiliation":[{"name":"Hospital Universitario 12 de Octubre","place":["Madrid, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3928-1554","authenticated-orcid":false,"given":"Laura","family":"Mourino\u2010\u00c1lvarez","sequence":"additional","affiliation":[{"name":"Hospital Nacional de Paraplejicos, SESCAM","place":["Toledo, Spain"]},{"name":"Hospital Nacional de Paraplejicos, IDISCAM","place":["Toledo, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7219-202X","authenticated-orcid":false,"given":"Marta","family":"Gil\u2010Fern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Hospital Universitario La Paz","place":["Madrid, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5911-9589","authenticated-orcid":false,"given":"Nerea","family":"Corbacho\u2010Alonso","sequence":"additional","affiliation":[{"name":"Hospital Nacional de Paraplejicos, SESCAM","place":["Toledo, Spain"]},{"name":"Hospital Nacional de Paraplejicos, IDISCAM","place":["Toledo, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0317-4888","authenticated-orcid":false,"given":"Jos\u00e9 Alberto","family":"Navarro\u2010Garc\u00eda","sequence":"additional","affiliation":[{"name":"Hospital Universitario 12 de Octubre","place":["Madrid, Spain"]},{"name":"RICORS2040\u2010Renal, ISCIII","place":["Madrid, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-7033-8166","authenticated-orcid":false,"given":"Elisa","family":"Mercado\u2010Garc\u00eda","sequence":"additional","affiliation":[{"name":"Hospital Universitario 12 de Octubre","place":["Madrid, Spain"]},{"name":"RICORS2040\u2010Renal, ISCIII","place":["Madrid, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8576-1970","authenticated-orcid":false,"given":"Laura","family":"Gonz\u00e1lez\u2010Lafuente","sequence":"additional","affiliation":[{"name":"Hospital Universitario 12 de Octubre","place":["Madrid, Spain"]},{"name":"RICORS2040\u2010Renal, ISCIII","place":["Madrid, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5020-949X","authenticated-orcid":false,"given":"Elena","family":"Rodr\u00edguez\u2010S\u00e1nchez","sequence":"additional","affiliation":[{"name":"Hospital Universitario 12 de Octubre","place":["Madrid, Spain"]},{"name":"RICORS2040\u2010Renal, ISCIII","place":["Madrid, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6367-2814","authenticated-orcid":false,"given":"Daniel","family":"Gonz\u00e1lez\u2010Moreno","sequence":"additional","affiliation":[{"name":"Hospital Universitario 12 de Octubre","place":["Madrid, Spain"]},{"name":"RICORS2040\u2010Renal, ISCIII","place":["Madrid, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3644-2914","authenticated-orcid":false,"given":"Alberto","family":"P\u00e9rez\u2010G\u00f3mez","sequence":"additional","affiliation":[{"name":"Hospital Universitario 12 de Octubre","place":["Madrid, Spain"]},{"name":"RICORS2040\u2010Renal, ISCIII","place":["Madrid, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Matutano","sequence":"additional","affiliation":[{"name":"Hospital Universitario Puerta de Hierro\u2010Majadahonda","place":["Madrid, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1461-5092","authenticated-orcid":false,"given":"Jes\u00fas","family":"V\u00e1zquez","sequence":"additional","affiliation":[{"name":"Centro Nacional de Investigaciones Cardiovasculares (CNIC)","place":["Madrid, Spain"]},{"name":"Instituto de Salud Carlos III","place":["Madrid, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9097-6060","authenticated-orcid":false,"given":"Juan Antonio","family":"L\u00f3pez","sequence":"additional","affiliation":[{"name":"Centro Nacional de Investigaciones Cardiovasculares (CNIC)","place":["Madrid, Spain"]},{"name":"Instituto de Salud Carlos III","place":["Madrid, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda","family":"Fern\u00e1ndez\u2010Velasco","sequence":"additional","affiliation":[{"name":"Hospital Universitario La Paz","place":["Madrid, Spain"]},{"name":"Instituto de Salud Carlos III","place":["Madrid, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4290-4721","authenticated-orcid":false,"given":"Mar\u00eda G.","family":"Barderas","sequence":"additional","affiliation":[{"name":"Hospital Nacional de Paraplejicos, SESCAM","place":["Toledo, Spain"]},{"name":"Hospital Nacional de Paraplejicos, IDISCAM","place":["Toledo, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3482-0915","authenticated-orcid":false,"given":"Gema","family":"Ruiz\u2010Hurtado","sequence":"additional","affiliation":[{"name":"Hospital Universitario 12 de Octubre","place":["Madrid, Spain"]},{"name":"RICORS2040\u2010Renal, ISCIII","place":["Madrid, Spain"]},{"name":"Universidad Aut\u00f3noma de Madrid","place":["Madrid, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.118.031373"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehs184"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.2174\/1573403X16999201210195702"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.3386"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10157-016-1357-6"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2021.775029"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ando.2020.03.007"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1530\/JME-20-0178"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2021.632260"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2018.00189"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2018.00278"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2013-304746"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopha.2022.113515"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejphar.2019.172549"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-021-02209-9"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s13105-023-00945-5"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1002\/path.6388"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61602-X"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pbio.3000410"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1038\/nmeth.1322"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1007\/s13361-015-1201-3"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.3390\/proteomes9010015"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.4172\/jpb.1000404"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.csbj.2023.12.034"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1093\/bioinformatics\/bty815"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1021\/pr800362h"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1074\/mcp.M115.055905"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1038\/nprot.2008.211"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1093\/nar\/gkn923"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.148.3.6878708"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehac262"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11051266"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1002\/ehf2.14568"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2023.1173281"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11030601"},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00392-020-01729-3"},{"key":"e_1_3_2_38_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2014.08.037"},{"key":"e_1_3_2_39_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2014.03.026"},{"key":"e_1_3_2_40_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-022-12385-0"},{"key":"e_1_3_2_41_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejim.2020.09.022"},{"key":"e_1_3_2_42_2","doi-asserted-by":"publisher","DOI":"10.1111\/nep.13780"},{"key":"e_1_3_2_43_2","doi-asserted-by":"publisher","DOI":"10.2147\/IJNRD.S304143"},{"key":"e_1_3_2_44_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00439-016-1636-z"},{"key":"e_1_3_2_45_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurjpc\/zwaf001"},{"key":"e_1_3_2_46_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurjpc\/zwaf053"},{"key":"e_1_3_2_47_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11123558"},{"key":"e_1_3_2_48_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiochem.2021.09.001"},{"key":"e_1_3_2_49_2","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.2576"},{"key":"e_1_3_2_50_2","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-17-0826"},{"key":"e_1_3_2_51_2","doi-asserted-by":"publisher","DOI":"10.1002\/ehf2.12416"},{"key":"e_1_3_2_52_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12872-023-03441-2"},{"key":"e_1_3_2_53_2","doi-asserted-by":"publisher","DOI":"10.5603\/CJ.a2018.0033"},{"key":"e_1_3_2_54_2","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.12356"},{"key":"e_1_3_2_55_2","doi-asserted-by":"publisher","DOI":"10.1159\/000535133"},{"key":"e_1_3_2_56_2","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.1424"},{"key":"e_1_3_2_57_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.heliyon.2024.e27939"},{"key":"e_1_3_2_58_2","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/glab308"},{"key":"e_1_3_2_59_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12872-022-02885-2"},{"key":"e_1_3_2_60_2","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2022.899307"},{"key":"e_1_3_2_61_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.trsl.2022.01.002"},{"key":"e_1_3_2_62_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mad.2022.111714"},{"key":"e_1_3_2_63_2","doi-asserted-by":"publisher","DOI":"10.1002\/jbmr.2527"},{"key":"e_1_3_2_64_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.carpath.2019.02.001"},{"key":"e_1_3_2_65_2","doi-asserted-by":"publisher","DOI":"10.11909\/j.issn.1671-5411.2016.08.009"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.125.045175","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T06:25:17Z","timestamp":1775802317000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.125.045175"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,17]]},"references-count":64,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,2,17]]}},"alternative-id":["10.1161\/JAHA.125.045175"],"URL":"https:\/\/doi.org\/10.1161\/jaha.125.045175","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,17]]},"assertion":[{"value":"2025-07-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-05","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-12","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e045175"}}