4.0 Article

Cardiac Biomarkers and Risk of Atherosclerotic Cardiovascular Disease in Patients with CKD

期刊

KIDNEY360
卷 3, 期 5, 页码 859-871

出版社

AMER SOC NEPHROLOGY
DOI: 10.34067/KID.0006222021

关键词

chronic kidney disease; atherosclerosis; biomarkers; cardiovascular disease; GDF-15; hsTnT; NT-proBNP; sST2

资金

  1. National Institute of Diabetes and Digestive and Kidney Diseases [U01DK060990, U01DK060984, U01DK061022, U01DK061021, U01DK061028, U01DK060980, U01DK060963, U01DK060902, U24DK060990]
  2. Perelman School of Medicine at the University of Pennsylvania Clinical and Translational Science Award National Institutes of Health (NIH)/National Center for Advancing Translational Sciences (NCATS) [UL1TR000003]
  3. Johns Hopkins University [UL1 TR-000424]
  4. University of Maryland General Clinical Research Center [M01 RR-16500]
  5. Clinical and Translational Science Collaborative of Cleveland
  6. Michigan Institute for Clinical and Health Research [UL1TR000433]
  7. University of Illinois at Chicago Center for Clinical and Translational Science [UL1RR029879]
  8. Tulane Center of Biomedical Research Excellence for Clinical and Translational Research in Cardiometabolic Diseases [P20 GM109036]
  9. Kaiser Permanente NIH/National Center for Research Resources University of California San Francisco Clinical and Translational Science Institute [UL1 RR-024131]
  10. Department of Internal Medicine, University of New Mexico School of Medicine Albuquerque [R01DK119199]
  11. Roche Diagnostics
  12. NCATS component of the NIH [UL1TR000439]

向作者/读者索取更多资源

This study analyzed the association between several cardiac biomarkers and atherosclerotic cardiovascular disease in patients with CKD. The results showed that NT-proBNP, hsTnT, GDF-15, and sST2 were significantly associated with atherosclerotic diseases such as myocardial infarction and stroke.
Background Several cardiac biomarkers of cardiac stress, inflammation, and fibrosis (N-terminal pro brain-type natriuretic peptide [NT-proBNP], high-sensitivity troponin T [hsTnT], growth differentiation factor 15 [GDF-15], and soluble ST2 [sST2]) have been associated with atherosclerotic disease in the general population. We hypothesized that these cardiac biomarkers may also be associated with the atherosclerotic cardiovascular disease in patients with CKD. Methods We analyzed levels of NT-proBNP, hsTnT, GDF-15, and sST2 in a cohort of 2732 participants with mild to moderate CKD from the Chronic Renal Insufficiency Cohort (CRIC) study. Outcomes included incident atherosclerotic disease, defined as the first instance of myocardial infarction, stroke, or peripheral vascular disease. We used Cox proportional hazard models to the test the association of each cardiac biomarker with risk of incident atherosclerotic disease, adjusting for multiple possible confounders. Results When modeled continuously (per SD increase in the log-transformed biomarker), NT-proBNP, hsTnT, GDF-15, and sST2 were significantly associated with incident atherosclerotic disease after adjustment for multiple potential confounders: (NT-proBNP HR, 1.51; 95% CI, 1.27 to 1.81; hsTnT HR, 1.61; 95% CI, 1.38 to 1.89; GDF-15 HR, 1.44; 95% CI, 1.19 to 1.73; and sST2 HR, 1.19; 95% CI, 1.04 to 1.36). Conclusions NT-proBNP, hsTnT, GDF-15, and sST2 were significantly associated with incident atherosclerotic cardiovascular disease in patients with CKD. These associations may highlight important mechanisms for the development of atherosclerotic disease in CKD.

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