Association of N-Terminal Pro-B-Type Natriuretic Peptide With Contrast-Induced Nephropathy and Long-Term Outcomes in Patients With Chronic Kidney Disease and Relative Preserved Left Ventricular Function

Liu, Yuanhui; Liu, Yong; Zhou, Yingling; Yu, Danqing; He, Pengcheng; Xie, Nianjin; Li, Hualong; Weiguo,; Chen, Jiyan; Tan, Ning

doi:10.1097/md.0000000000000358

Cited by 9 publications

(10 citation statements)

References 39 publications

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“…Our current study is in agreement with Goussot et al .’s work, since NT-proBNP is strongly associated with ICA-induced AKI. In our analysis, the threshold value of 512 pg/mL (Se 81%, Sp 66%) was very close to the data in the literature 42,43 . This biomarker is usually increased in cases of myocardial injury 44 .…”

Section: Discussionsupporting

confidence: 90%

Retinal Vascular Density as A Novel Biomarker of Acute Renal Injury after Acute Coronary Syndrome

Alan

Guenancia

Arnould

et al. 2019

Sci Rep

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Iodinated contrast agent (ICA)-induced acute kidney injury (AKI) following acute coronary syndrome (ACS) is a frequent complication, which may lead to chronic kidney disease and increased mortality. Optical coherence tomography angiography (OCT-A) of the retina is new tool delivering a rapid and noninvasive assessment of systemic microvascularization, which is potentially involved in the occurrence of ICA-induced AKI. Between October 2016 and March 2017, 452 ACS patients were admitted to our cardiac intensive care unit. OCT-A was performed within 48 h after the ICA injection. Patients with a history of retinal disease were excluded. The patients included were divided into two groups depending on whether or not AKI occurred after injection of ICA, according to KDIGO criteria. Of the 216 patients included, 21 (10%) presented AKI. AKI was significantly associated with age, Mehran score, GRACE score, and NT-proBNP. AKI patients had significantly lower retinal vascular density (RVD)) and had more frequent low RVD (81% vs 45%, P = 0.002). Adding low RVD to the Mehran score and the NT-proBNP, or to the GRACE score and the NT-proBNP, significantly improved their predictive values, suggesting that systemic microvascular involvement remains incompletely addressed by either standard risk scores or factors known to be associated with ICA-induced AKI.

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Section: Discussionsupporting

confidence: 90%

Retinal Vascular Density as A Novel Biomarker of Acute Renal Injury after Acute Coronary Syndrome

Alan

Guenancia

Arnould

et al. 2019

Sci Rep

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“…[ 17 ] In contrast, patients with HFmrEF may receive less attention than those with HFrEF, despite typically being older and thus more likely to have comorbid risk for CI-AKI, such as hypertension, diabetes, anemia, and renal insufficiency. [ 18 ] Furthermore, recent studies indicate that the CI-AKI incidence in patients with LVEF ≥40% is 5.2% to 7.8%, [ 19 , 20 ] ranging up to 12.0% in the subgroup with CKD. [ 20 ] However, these studies included patients with unselected cardiac function and it is well established that, the incidence of renal insufficiency and other adverse events is higher in patients with HF than in those without HF.…”

Section: Discussionmentioning

confidence: 99%

“…[ 18 ] Furthermore, recent studies indicate that the CI-AKI incidence in patients with LVEF ≥40% is 5.2% to 7.8%, [ 19 , 20 ] ranging up to 12.0% in the subgroup with CKD. [ 20 ] However, these studies included patients with unselected cardiac function and it is well established that, the incidence of renal insufficiency and other adverse events is higher in patients with HF than in those without HF. [ 9 ] In this study, the incidence of CI-AKI was 12.1% in all patients and 19.3% in patients with CKD, consistent with the higher risk associated with HFmrEF.…”

Section: Discussionmentioning

confidence: 99%

Association of N-terminal pro-brain natriuretic peptide with contrast-induced acute kidney injury and long-term mortality in patients with heart failure and mid-range ejection fraction

Wang

Chen

et al. 2017

Medicine

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The potential value of N-terminal pro-brain natriuretic peptide (NT-proBNP) for contrast-induced acute kidney injury (CI-AKI) in patients with heart failure and mid-range ejection fraction (HFmrEF) is unclear. We investigated whether NT-proBNP is associated with CI-AKI and long-term mortality following elective cardiac catheterization in patients with HFmrEF.A total of 174 consecutive patients with HFmrEF undergoing elective coronary angiography or intervention were enrolled. The primary endpoint was the development of CI-AKI, defined as an absolute increase of ≥0.3 mg/dL or ≥ 50% from baseline serum creatinine with 48 hours after contrast medium exposure. Receiver-operating characteristic curve analysis was conducted, and Youden index was used to determine the best cutoff NT-proBNP value. Multivariable logistic regression and Cox proportional hazards regression analyses were performed to identify the independent risk factors for CI-AKI and long-term mortality, respectively.The incidence of CI-AKI was 12.1%. Patients with CI-AKI had higher NT-proBNP values than those without (4373[1561.9–7470.5] vs 1303[625.2–2482.3], P = 0.003). Receiver-operating characteristic curve revealed that NT-proBNP was not significantly different from the Mehran risk score in predicting CI-AKI (area under the curve [AUC] = 0.723 vs 0.767, P = 0.516). The best cutoff NT-proBNP value for CI-AKI was 3299 pg/mL, with 70.6% sensitivity and 83.1% specificity. Multivariable analysis demonstrated that NT-proBNP ≥3299 pg/mL is significantly related to CI-AKI (odds ratio = 12.79; 95% confidence interval, 3.18–51.49; P < 0.001). Cox regression analysis showed that NT-proBNP ≥3299 pg/mL is associated with long-term mortality (adjusted hazard ratio = 11.91; 95%CI, 2.16–65.70; P = 0.004) during follow-up.In patients with HFmrEF, NT-proBNP ≥3299 pg/mL is associated with CI-AKI and long-term mortality following elective coronary angiography or intervention.

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“…As a recognized independent prognostic factor, NT-proBNP has a higher sensitivity, but its specificity is affected by many non-cardiac factors, which often brings certain limitations to clinical diagnosis and evaluation. At present, for most countries in the world, medical workers analyze the condition and prognosticate AHF by using the way that combines cardiac troponin I/T(cTnI/T), hemoglobin, cystatin, and others in clinical practice (15)(16)(17)(18). In this study, renal related markers were analyzed to explore the prognostic value of NT-proBNP combined with GFR for long-term survival in AHF patients.…”

Section: Introductionmentioning

confidence: 99%

Prognostic Value of N-Terminal Pro-B-Type Natriuretic Peptide and Glomerular Filtration Rate in Patients With Acute Heart Failure

Wang

et al. 2020

Front. Cardiovasc. Med.

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Aims: To investigate the relationship between N-terminal pro-B-type natriuretic peptide (NT-proBNP), Glomerular Filtration Rate (GFR), and outcomes in patients hospitalized with acute heart failure (AHF). Methods: The trial was registered at http://www.chictr.org/cn/. (ChiCTR-ONC-12001944). A total of 493 patients hospitalized for AHF in cardiology department of the First Affiliated Hospital of Nanjing Medical University from March 2012 to October 2016 were enrolled into registry. The end event was the occurrence of all-cause death within an 18-month follow-up. The data collected from the participants in admission were used to calculate the GFR by chronic kidney disease epidemiology collaboration equation (CKD-EPI) and performed the according statistical analysis. Results: There were 74 participants (13.8%) dropped out and 91 (21.7%) passed away within the 18-month follow up. Comparison of clinical indicators between survival and death group were analyzed for the long-term prognosis of patients with AHF. In the single factor analysis, both NT-proBNP and GFR were statistically significant (P < 0.001). Combined NT-proBNP and GFR in multi-factor COX regression analysis showed significant predictive value (P < 0.001). In receiver operator characteristics (ROC) analyses, the area under the curves (AUC) for NT-proBNP was 0.648 [95%CI: 0.598-0.695, P < 0.001] and for GFR was 0.677 [95%CI: 0.627-0.723, P < 0.001]. According to the Youden index, the best prediction point of NT-proBNP was 2,137 pg/ml and GFR was 61.7 ml/(min•1.73 m 2). After using the Binary Logistic Regression to combine the two indicators, the AUC was 0.711, which was significantly compared to the AUC of either single factor. The sensitivity of the combined indicators were 0.535, the specificity were 0.853. According to the cutoff point, these two indexes were separated into four groups for further analysis by Kaplan-Meier survival curve comparison (log-rank test), which showed that patients in the group with higher NT-proBNP and lower GFR had the worst prognosis. Wang et al. GFR in AHF Patients Conclusions: In patients with NT-proBNP > 2,137 pg/ml and GFR < 61.7 ml/(min•1.73 m 2), the risk of death was significantly higher. The combination of GFR and NT-proBNP improved the predictive value for the long-term prognosis of AHF patients.

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Association of N-Terminal Pro-B-Type Natriuretic Peptide With Contrast-Induced Nephropathy and Long-Term Outcomes in Patients With Chronic Kidney Disease and Relative Preserved Left Ventricular Function

Cited by 9 publications

References 39 publications

Retinal Vascular Density as A Novel Biomarker of Acute Renal Injury after Acute Coronary Syndrome

Retinal Vascular Density as A Novel Biomarker of Acute Renal Injury after Acute Coronary Syndrome

Association of N-terminal pro-brain natriuretic peptide with contrast-induced acute kidney injury and long-term mortality in patients with heart failure and mid-range ejection fraction

Prognostic Value of N-Terminal Pro-B-Type Natriuretic Peptide and Glomerular Filtration Rate in Patients With Acute Heart Failure

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