1 3 J Endocrinol Invest DOI 10.1007/s40618-016-0561-2 ORIGINAL ARTICLE Secondary hyperparathyroidism prevalence and prognostic role in elderly males with heart failure G. Loncar 1,2 · B. Bozic 3,4 · N. Cvetinovic 1 · H.-D. Dungen 5 · M. Lainscak 6,7 · S. von Haehling 8,9 · W. Doehner 10 · Z. Radojicic 11 · B. Putnikovic 2,12 · T. Trippel 5 · V. Popovic 2,13 Received: 1 August 2016 / Accepted: 5 October 2016 © Italian Society of Endocrinology (SIE) 2016 in age, vitamin D status, and renal function were noted between studied groups. A total of 41 (56 %) patients died within 6 years of follow-up. Kaplan–Meier survival analy- sis showed impaired long-term survival in patients with SHPT versus patients with normal PTH (p = 0.009). The rate of death was highest (75 %) in the group of patients with SHPT and NT-proBNP levels above median value (p = 0.003). Cox regression analysis demonstrated that NT- proBNP was the single independent predictor of all-cause mortality at 6-year follow-up [HR 3.698 (1.927–7.095), p < 0.0001]. Conclusion SHPT was highly prevalent in elderly males with HF and was associated with impaired survival. HF patients with SHPT had more severe disease compared to the patients with normal serum PTH. Determination of serum PTH levels provided additional value to NT-proBNP for risk stratification in these patients. Abstract Aim Evaluation of secondary hyperparathyroidism (SHPT) and its prognostic impact on all-cause mortality in elderly males with heart failure (HF). Methods Seventy three males (67 ± 7 years old) with systolic HF were included. Baseline PTH was measured. Patients were grouped according to PTH cut-off levels of 65 pg/ml (>65 pg/ml = SHPT vs. normal PTH). All-cause mortality was evaluated at 6-year follow-up. Results SHPT was diagnosed in 43 (59 %) patients. They were more severe compared to the patients with normal PTH regarding NYHA functional class (2.4 ± 0.5 vs. 2.1 ± 0.2, p = 0.001), quality of life score (34 ± 14 vs. 24 ± 12, p = 0.005), 6-min walking distance (378 ± 79 vs. 446 ± 73 m, p < 0.0001), left ventricular ejection fraction (27 ± 8 vs. 31 ± 7 %, p = 0.019), and NT-proBNP [2452 (3399) vs. 918 (1372) pg/ml, p < 0.0001]. No differences * G. Loncar loncar_goran@yahoo.com 1 Cardiology Department, Clinical Hospital Zvezdara, Dimitrija Tucovica 161, Belgrade 11 000, Serbia 2 Faculty of Medicine, University of Belgrade, Belgrade, Serbia 3 Institute for Medical Research, Military Medical Academy, Belgrade, Serbia 4 Institute for Physiology and Biochemistry, University of Belgrade, Belgrade, Serbia 5 Department of Cardiology, Campus Virchow, Charité Universitätsmedizin Berlin, Berlin, Germany 6 Departments of Cardiology and Research and Education, General Hospital Celje, Celje, Slovenia 7 Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia 8 Innovative Clinical Trials, Department of Cardiology and Pneumology, University of Medicine Göttingen, Göttingen, Germany 9 Applied Cachexia Research, Department of Cardiology, Charité-University Medical School, Campus Virchow-Klinikum, Berlin, Germany 10 Center for Stroke Research Berlin, Charite University Medical School, Berlin, Germany 11 Institute for Statistics, Faculty of Organizational Sciences, University of Belgrade, Belgrade, Serbia 12 Cardiology Department, Clinical Hospital Center Zemun, Belgrade, Serbia 13 Institute of Endocrinology, Clinical Center of Serbia, Belgrade, Serbia