Journal of the American Society of Nephrology. 2015. 26(4):946-956.
In a recent study, there was strong association between high-sensitivity troponin T (hsTnT and N-terminal pro-B-type natriuretic peptide (NT-proBNP) and incident heart failure in individuals with mild to severe chronic kidney disease (CKD). These biomarkers are strong predictors of heart failure in the general population. Nisha Bansal, MD, MS, and colleagues conducted the study to determine whether there is an association between hsTnT and NT-proBNP and incident heart failure among patients with CKD.
The prospective cohort analysis included 3483 CKD patients in the Chronic Renal Insufficiency Cohort (CRIC) study who were recruited from June 2003 to August 2008. All 3483 patients were free of hear failure at baseline. Following adjustment for demographic factors, traditional cardiovascular risk factors, markers of kidney disease, pertinent medication use, and mineral metabolism markers, Cox regression was used to assess the association of baseline levels of hsTnT and NT-proBNP with incident heart failure.
Baseline levels of hsTnT ranged from ≤5 to 35,000 pg/mL. Compared with patients with undetectable hsTnT, those in the highest quartile (>26.5 ng/ML) had a significantly higher rate of heart failure (hazard ratio [HR], 4.77; 95% confidence interval [CI], 2.49-9.14). Further, compared with those in the lowest NT-proBNP quintile (<47.6 ng/mL), those in the highest quintile (>433.0 ng/mL) had a higher rate of heart failure (HR, 9.57; 95% CI, 4.40-20.83).
In conclusion the researchers said, “hsTnT and NY-proBNP were strongly associated with incident heart failure among a divers 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 heart failure.”