High-Sensitivity Troponin T and N-Terminal Pro-B-Type Natriuretic Peptide (NT-proBNP) and Risk of Incident Heart Failure in Patients with CKD
Year: 2014
Type: article
Study design: Observational Study
Abstract: High-sensitivity troponin T (hsTnT) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) strongly predict heart failure (HF) in the general population. However, the interpretation of levels of these biomarkers as predictors of HF is uncertain among patients with CKD. Here, we investigated whether hsTnT and NT-proBNP are associated with incident HF among patients with CKD. In a prospective cohort analysis, we studied 3483 people with CKD in the Chronic Renal Insufficiency Cohort (CRIC) Study recruited from June of 2003 to August of 2008 who were free of HF at baseline. We used Cox regression to examine the association of baseline levels of hsTnT and NT-proBNP with incident HF after adjustment for demographic factors, traditional cardiovascular risk factors, markers of kidney disease, pertinent medication use, and mineral metabolism markers. At baseline, hsTnT levels ranged from ≤5.0 to 738.7 pg/ml, and NT-proBNP levels ranged from ≤5 to 35,000 pg/ml. Compared with those who had undetectable hsTnT, participants in the highest quartile (>26.5 pg/ml) had a significantly higher rate of HF (hazard ratio, 4.77; 95% confidence interval, 2.49 to 9.14). Similarly, compared with those in the lowest NT-proBNP quintile (<47.6 pg/ml), participants in the highest quintile (>433.0 pg/ml) experienced a substantially higher rate of HF (hazard ratio, 9.57; 95% confidence interval, 4.40 to 20.83) [corrected]. In conclusion, hsTnT and NT-proBNP were strongly associated with incident HF among a diverse cohort of individuals with mild to severe CKD. Elevations in these biomarkers may indicate subclinical changes in volume and myocardial stress that subsequently contribute to clinical HF.
Institutions: University of Washington, University of Pennsylvania, University of Maryland, Baltimore, Yale University, Kaiser Permanente, Kaiser Permanente Northern California, Tulane University, National Institutes of Health, University of Illinois Chicago, George Washington University, Northwestern University, University of California, San Francisco
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
Awards: G1355330398, Clinical and Translational Science Institute, Heart failure and atrial arrhythmias in CKD, Modifiable and Biochemical Predictors and Consequences of Acute Kidney Injury, Heart Failure Incidence and Progression in Renal Disease, Hispanic Chronic Renal Insufficiency Cohort(CRIC) Study, G243530825, Continuation of the Chronic Renal Insufficiency Cohort (CRIC) Study, General Clinical Research Center, G3562949498, Mentored Patient Oriented Research in Mineral Metabolism, G36850890, Translational Research in Hypertension and Renal Biology, Blood Pressure in Advanced Chronic Kidney Disease, FGF23 and Cardiovascular Disease in CKD, Center for Clinical and Translational Science, Michigan Institute for Clinical and Health Research (MCHR), CKD the metabolic syndrome & cardiovascular illness, Institute for Clinical and Translational Research, Institutional Clinical and Translational Science Award, Clinical and Translational Science Collaborative of Cleveland, A pilot trial of an intervention to support initial type 2 diabetes selfmanagement among younger adults with children., Prospective renal insufficiency cohort evaluation: PRICE, Chronic Renal Insufficiency Cohort (CRIC) Study Clinical Center, Continuation of the University of Illinois Chicago CRIC Clinical Center, Limited Competition for the Continuation of the Chronic Renal Insufficiency Cohort (CRIC) Hopkins Clinical Center, Tulane Clinical Center for Chronic Renal Insufficiency Cohort Study, Chronic Renal Insufficiency Cohort Limited competition continuation, Chronic Renal Insufficiency Cohort (CRIC) Study
OpenAlex ID: W2129285632