دورية أكاديمية
B-Type Natriuretic Peptide and Cardiac Troponin I Are Associated With Adverse Outcomes in Stable Kidney Transplant Recipients.
العنوان: | B-Type Natriuretic Peptide and Cardiac Troponin I Are Associated With Adverse Outcomes in Stable Kidney Transplant Recipients. |
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المؤلفون: | Jarolim P; 1 Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA. 2 Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA. 3 Department of Biostatistics, University of North Carolina, Chapel Hill, NC. 4 Division of Nephrology, Rhode Island Hospital, Providence, RI. 5 National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD. 6 University of Iowa, Iowa City, IA. 7 US Department of Agriculture, Jean Mayer Human Nutrition Research Center on Aging, Boston, MA. 8 Tufts Medical Center, Boston, MA., Claggett BL, Conrad MJ, Carpenter MA, Ivanova A, Bostom AG, Kusek JW, Hunsicker LG, Jacques PF, Gravens-Mueller L, Finn P, Solomon SD, Weiner DE, Levey AS, Pfeffer MA |
المصدر: | Transplantation [Transplantation] 2017 Jan; Vol. 101 (1), pp. 182-190. |
نوع المنشور: | Journal Article; Multicenter Study; Observational Study |
اللغة: | English |
بيانات الدورية: | Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 0132144 Publication Model: Print Cited Medium: Internet ISSN: 1534-6080 (Electronic) Linking ISSN: 00411337 NLM ISO Abbreviation: Transplantation Subsets: MEDLINE |
أسماء مطبوعة: | Publication: Hagerstown, MD : Lippincott Williams & Wilkins Original Publication: Baltimore, Williams & Wilkins. |
مواضيع طبية MeSH: | Transplant Recipients*, Cardiovascular Diseases/*blood , Kidney Transplantation/*adverse effects , Natriuretic Peptide, Brain/*blood , Troponin I/*blood, Adult ; Biomarkers/blood ; Cardiovascular Diseases/diagnosis ; Cardiovascular Diseases/etiology ; Cardiovascular Diseases/mortality ; Case-Control Studies ; Female ; Humans ; Kidney Transplantation/mortality ; Male ; Middle Aged ; Predictive Value of Tests ; Randomized Controlled Trials as Topic ; Risk Factors ; Treatment Outcome ; Up-Regulation |
مستخلص: | Background: Approximately 200 000 kidney transplant recipients are living in the United States; they are at increased risk for cardiovascular and other adverse outcomes. Biomarkers predicting these outcomes are needed. Using specimens collected during the Folic Acid for Vascular Outcome Reduction in Transplantation trial, we determined whether plasma levels of B-type natriuretic peptide (BNP) and cardiac troponin I are associated with adverse outcomes in stable kidney transplant recipients. Methods: Five hundred ten subjects were selected randomly from the 4110 Folic Acid for Vascular Outcome Reduction in Transplantation participants. This cohort was then enriched for all additional subjects with adverse outcomes (death, dialysis-dependent kidney failure (DDKF), and cardiovascular outcomes) for a total of 1131 participants studied. Quartiles of BNP and high-sensitivity cardiac troponin I (hs-cTnI) were included in adjusted models. Combinations of normal and elevated hs-cTnI (>26.2 ng/L) and BNP (>100 pg/mL) were also studied. Results: Median concentrations (interquartile ranges) were 5.6 (3.3-10.5) ng/L for hs-cTnI and 39 (15, 94) pg/mL for BNP. Hazard ratios for each adverse outcome were higher with higher quartiles of BNP after adjustment and remained statistically significant after adding hs-cTnI to the model. The highest quartile hazard ratio for DDKF was 2.47 (95% confidence interval [95% CI], 1.21-5.05). Simultaneous elevations of BNP and hs-cTnI over clinical cutoffs were strongly associated with adverse outcomes with hazard ratios 8.8 (95% CI, 3.4-23.1) for DDKF and 6.3 (95% CI, 2.7-15.0) for cardiovascular outcomes. Conclusions: Higher BNP is associated with mortality and cardiovascular and kidney outcomes in stable kidney transplant recipients. Elevated BNP and hs-cTnI identify candidates for targeted risk reduction. |
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معلومات مُعتمدة: | U01 DK061700 United States DK NIDDK NIH HHS |
المشرفين على المادة: | 0 (Biomarkers) 0 (Troponin I) 114471-18-0 (Natriuretic Peptide, Brain) |
تواريخ الأحداث: | Date Created: 20160225 Date Completed: 20170523 Latest Revision: 20181113 |
رمز التحديث: | 20240628 |
مُعرف محوري في PubMed: | PMC4956594 |
DOI: | 10.1097/TP.0000000000001080 |
PMID: | 26910333 |
قاعدة البيانات: | MEDLINE |
تدمد: | 1534-6080 |
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DOI: | 10.1097/TP.0000000000001080 |