Superior Predictive Value for NTproBNP Compared with High Sensitivity cTnT in Dialysis Patients: A Pilot Prospective Observational Study

Voroneanu, Luminița; Siriopol, Dimitrie; Nistor, Ionuţ; Apetrii, Mugurel; Hogaş, Simona; Onofriescu, Mihai; Covic, Adrian

doi:10.1159/000368452

Cited by 20 publications

(19 citation statements)

References 29 publications

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“…NT‐proBNP is useful to establish a prognosis in heart failure and to identify asymptomatic or symptomatic left ventricular dysfunction, coronary artery disease and myocardial ischemia. In HD patients, NT‐proBNP was proved to be a screener of asymptomatic cardiac disease, a strong predictor of overall mortality in HD patients . Our finding that MLR being positively associated with NT‐proBNP indicated the MLR might be correlated with cardiac function, which was also consistent with our main finding that MLR served as a predictor of CVD deaths in HD patients.…”

Section: Discussionsupporting

confidence: 90%

Monocyte/lymphocyte ratio as a better predictor of cardiovascular and all‐cause mortality in hemodialysis patients: A prospective cohort study

Fei

Chen

Cao

et al. 2017

Hemodialysis International

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Section: Discussionsupporting

confidence: 90%

Monocyte/lymphocyte ratio as a better predictor of cardiovascular and all‐cause mortality in hemodialysis patients: A prospective cohort study

Fei

Chen

Cao

et al. 2017

Hemodialysis International

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“…This is the first study to show that hs‐cTnT is also an independent predictor of MACE. These findings are inconsistent with Voroneanu et al, who found that hs‐cTnT was not an independent predictor for all‐cause mortality in hemodialysis patients at 24 months . This inconsistency could be attributed to the difference in sample size, follow‐up period, and analysis method.…”

Section: Discussionmentioning

confidence: 65%

“…However, very few studies were performed with hs‐cTnT. The studies that were performed with hs‐cTnT, including the 1 we previously conducted, were limited by smaller sample size or shorter follow‐up period . In addition, information on PD patients is lacking.…”

Section: Discussionmentioning

confidence: 99%

High‐Sensitivity Troponin T and C‐Reactive Protein Have Different Prognostic Values in Hemo‐ and Peritoneal Dialysis Populations: A Cohort Study

Chen

Hassan

Qian

et al. 2018

JAHA

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BackgroundDialysis patients have an exceedingly high mortality rate. Biomarkers may be useful tools in risk stratification of this population. We evaluated the prognostic value of high‐sensitivity cardiac troponin T (hs‐cTnT) and CRP (C‐reactive protein) in predicting adverse outcomes in stable hemodialysis and peritoneal dialysis (PD) patients. Variability in hs‐cTnT was also examined.Methods and ResultsA retrospective cohort study included 574 dialysis patients (hemodialysis 347, PD 227). Outcomes examined included mortality and major adverse cardiovascular events, with median follow‐up of 3.5 years. hs‐cTnT was an independent predictor of both outcomes in hemodialysis and PD patients. Increased risk only became significant when hs‐cTnT reached quintile 3 (>49 ng/L). Area under the receiver operating curve analysis showed that the addition of hs‐cTnT to clinical parameters significantly improved its prognostic performance for mortality in PD patients (P=0.002). CRP was an independent predictor of both outcomes in PD patients only. Only CRP in the highest quintile (>16.8 mg/L) was associated with increased risk. hs‐cTnT remained relatively stable for the whole follow‐up period for hemodialysis patients, whereas for PD patients, hs‐cTnT increased by 23.63% in year 2 and 29.13% in year 3 compared with baseline (P<0.001).Conclusionshs‐cTnT and CRP are useful tools in predicting mortality and major adverse cardiovascular events in hemodialysis and PD patients. Given that hs‐cTnT levels increase over time in PD patients, interval monitoring may be valuable for risk assessment. In contrast, hs‐cTnT in hemodialysis patients has little interval change and progress monitoring is not indicated.

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“…The interpretation of NT pro-BNP in HD patients thus remains a complex issue not only due to its renal elimination but also due to a described increase in states of fluid overload [29]. Yet, it has previously been shown to be associated with higher mortality in HD patients [30] and has recently been successfully been implemented in the diagnostic process of HFrEF together with a lipid panel analysis and might therefore remain a practical tool for HF diagnosis in HD patients [31]. …”

Section: Discussionmentioning

confidence: 99%

Heart Failure with Preserved and Reduced Ejection Fraction in Hemodialysis Patients: Prevalence, Disease Prediction and Prognosis

Antlanger¹,

Aschauer

Kopecky³

et al. 2017

Kidney Blood Press Res

1,912

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Background/Aims: Heart failure (HF) is a main cause of mortality of hemodialysis (HD) patients. While HF with reduced ejection fraction (HFrEF) is known to only affect a minority of patients, little is known about the prevalence, associations with clinical characteristics and prognosis of HF with preserved ejection fraction (HFpEF). Methods: We included 105 maintenance HD patients from the Medical University of Vienna into this prospective single-center cohort study and determined the prevalence of HFpEF (per the 2013 criteria of the European Society of Cardiology) and HFrEF (EF <45%), using standardized post-HD transthoracic echocardiography. We also assessed clinical, laboratory and volume status parameters (by bioimpedance spectroscopy). These parameters served to calculate prediction models for both disease entities, while clinical outcomes (frequency of cardiovascular hospitalizations and/or cardiac death) were assessed prospectively over 27±4 months of follow-up. Results: All but 4 patients (96%) had evidence of diastolic dysfunction. 70% of the entire cohort fulfilled HF criteria (81% HFpEF, 19% HFrEF). Age, female sex, body mass index, blood pressure and dialysis vintage were predictive of HFpEF (sensitivity 86%, specificity 63%; AUC 0.87), while age, female sex, NT pro-BNP, history of coronary artery disease and atrial fibrillation were predictive of HFrEF (sensitivity 85%, specificity 90%; AUC 0.95). Compared to patients without HF, those with HFpEF and HFrEF had a higher risk of hospitalization for cardiovascular reason and/or cardiac death (adjusted HR 4.31, 95% CI 0.46-40.03; adjusted HR 3.24, 95% CI 1.08-9.75, respectively). Conclusion: Diastolic dysfunction and HFpEF are highly prevalent in HD patients while HFrEF only affects a minority. Distinct patient-specific characteristics predict diagnosis of either entity with good accuracy.

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Superior Predictive Value for NTproBNP Compared with High Sensitivity cTnT in Dialysis Patients: A Pilot Prospective Observational Study

Cited by 20 publications

References 29 publications

Monocyte/lymphocyte ratio as a better predictor of cardiovascular and all‐cause mortality in hemodialysis patients: A prospective cohort study

Monocyte/lymphocyte ratio as a better predictor of cardiovascular and all‐cause mortality in hemodialysis patients: A prospective cohort study

High‐Sensitivity Troponin T and C‐Reactive Protein Have Different Prognostic Values in Hemo‐ and Peritoneal Dialysis Populations: A Cohort Study

Heart Failure with Preserved and Reduced Ejection Fraction in Hemodialysis Patients: Prevalence, Disease Prediction and Prognosis

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