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NT-proBNP: is it a more significant risk factor for mortality than troponin T in incident hemodialysis patients?

 Hyung Jung Oh  ;  Mi Jung Lee  ;  Hye Sun Lee  ;  c  ;  Jung Tak Park  ;  Seung Hyeok Han  ;  Tae Hyun Yoo  ;  Yong Lim Kim  ;  Yon Su Kim  ;  Chul Woo Yang  ;  Nam Ho Kim  ;  Shin Wook Kang 
 MEDICINE, Vol.93(27) : 241, 2014 
Journal Title
Issue Date
Adult ; Aged ; Biomarkers/blood ; Cardiovascular Diseases/blood* ; Cardiovascular Diseases/complications ; Cardiovascular Diseases/mortality ; Female ; Humans ; Kidney Failure, Chronic/blood* ; Kidney Failure, Chronic/complications ; Kidney Failure, Chronic/mortality ; Male ; Middle Aged ; Natriuretic Peptide, Brain/blood* ; Peptide Fragments/blood* ; Prospective Studies ; Renal Dialysis ; Republic of Korea/epidemiology ; Troponin T/blood*
Numerous studies have demonstrated that cardiac biomarkers are significant predictors of cardiovascular (CV) and all-cause mortality in ESRD patients, but most of the studies were retrospective or included small numbers of patients, only prevalent dialysis patients, or measured 1 or 2 biomarkers. This study was to analyze the association between 3 cardiac biomarkers and mortality in incident HD patients. A prospective cohort of 864 incident HD patients was followed for 30 months. Based on the median values of baseline NT-proBNP, cTnT, and hsCRP, the patients were divided into "high" and "low" groups, and CV and all-cause mortality were compared between each group. Additionally, time-dependent ROC curves were constructed, and the NRI and IDI of the models with various biomarkers were calculated. The CV survival rates were significantly lower in the "high" NT-proBNP and cTnT groups compared to the corresponding "low" groups, while there was no significant difference in CV survival rate between the 2 hsCRP groups. However, all-cause mortality rates were significantly higher in all 3 "high" groups compared to each lower group. In multivariate analyses, only Ln NT-proBNP was found to be an independent predictor of mortality. Moreover, NT-proBNP was a more prognostic marker for mortality compared to cTnT. In conclusion, NT-proBNP is the biomarker that results in the most added prognostic value on top of traditional risk factors for CV and all-cause mortality in incident HD patients.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
Yonsei Authors
Kang, Shin Wook(강신욱) ORCID logo https://orcid.org/0000-0002-5677-4756
Park, Jung Tak(박정탁) ORCID logo https://orcid.org/0000-0002-2325-8982
Oh, Hyung Jung(오형중)
Yoo, Tae Hyun(유태현) ORCID logo https://orcid.org/0000-0002-9183-4507
Lee, Mi Jung(이미정)
Lee, Hye Sun(이혜선) ORCID logo https://orcid.org/0000-0001-6328-6948
Han, Seung Hyeok(한승혁) ORCID logo https://orcid.org/0000-0001-7923-5635
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