Cardiac troponin and C-reactive protein for predicting all-cause and cardiovascular mortality in patients with chronic kidney disease: A meta-analysis

Abstract

Elevated serum levels of cardiac troponin and C-reactive protein are associated with all-cause and cardiovascular mortality in patients with end-stage renal disease. However, the relationship between these two biomarker levels and mortality in patients with chronic kidney disease remains unclear. We conducted a meta-analysis to quantify the association of cardiac troponin and C-reactive protein levels with all-cause and cardiovascular mortality in patients with chronic kidney disease. Relevant studies were identified by searching the MEDLINE database through November 2013. Studies were included in the meta-analysis if they reported the long-term all-cause or cardiovascular mortality of chronic kidney disease patients with abnormally elevated serum levels of cardiac troponin or C-reactive protein. Summary estimates of association were obtained using a random-effects model. Thirty-two studies met our inclusion criteria. From the pooled analysis, cardiac troponin and C-reactive protein were significantly associated with all-cause (HR 2.93, 95% CI 1.97-4.33 and HR 1.21, 95% CI 1.14-1.29, respectively) and cardiovascular (HR 3.27, 95% CI 1.67-6.41 and HR 1.19, 95% CI 1.10-1.28, respectively) mortality. In the subgroup analysis of cardiac troponin and C-reactive protein, significant heterogeneities were found among the subgroups of population for renal replacement therapy and for the proportion of smokers and the C-reactive protein analysis method. Elevated serum levels of cardiac troponin and C-reactive protein are significant associated with higher risks of all-cause and cardiovascular mortality in patients with chronic kidney disease. Further studies are warranted to explore the risk stratification in chronic kidney disease patients.

Association between periodontitis and mortality in stages 3–5 chronic kidney disease: NHANES III and linked mortality study

“…This increased burden is seen in individuals with periodontitis and CKD (Ioannidou et al 2011) and individuals with periodontitis who do not have CKD (D'Aiuto et al 2004, Chapple & Genco 2013. Increased systemic inflammatory and oxidative stress burdens increase the incidence of CVD events in patients with CKD (Arici & Walls 2001, Mathew et al 2008, Li et al 2015. This mechanism is supported by the association demonstrated here between increased risk of CVD mortality and measures of active periodontitis (periodontitis case definition, mean PPD and BOP), as opposed to measures of historical periodontitis (edentulousness and mean CAL), where there was a lack of association (Table 2).…”

“…, Li et al. ). This mechanism is supported by the association demonstrated here between increased risk of CVD mortality and measures of active periodontitis (periodontitis case definition, mean PPD and BOP), as opposed to measures of historical periodontitis (edentulousness and mean CAL), where there was a lack of association (Table ).…”

Efficacy and Safety of Sevelamer Carbonate Versus Calcium Acetate in Patients With Chronic Renal Disease on Dialysis

“…22 It could perhaps be due to the short duration of the study. CRP is an acute phase reactant, elevated CRP levels are associated with increased cardiovascular mortality in CRD 23 . This study did not deduce significant reduction in CRP levels in either group.…”

Troponin Elevation in Chronic Kidney Disease: An Educational Project

“…In a study, Li, et al, (2015) performed a meta-analysis through a systematic search of studies pertinent published by November 2013 in the MEDLINE database.…”