High-Sensitivity Cardiac Troponin, Natriuretic Peptide, and Long-Term Risk of Acute Kidney Injury: The Atherosclerosis Risk in Communities (ARIC) Study.
Acute kidney injury
High-sensitivity cardiac troponin T
Hospitalization
N-terminal pro-B-type natriuretic hormone
Journal
Clinical chemistry
ISSN: 1530-8561
Titre abrégé: Clin Chem
Pays: England
ID NLM: 9421549
Informations de publication
Date de publication:
08 01 2021
08 01 2021
Historique:
received:
19
09
2020
accepted:
28
10
2020
entrez:
8
1
2021
pubmed:
9
1
2021
medline:
7
7
2021
Statut:
ppublish
Résumé
Cardiac markers such as high-sensitivity cardiac troponin T (hs-cTnT) and N-terminal pro-B natriuretic peptide (NTproBNP) are predictors of developing acute kidney injury (AKI) during hospitalization for surgery or revascularization. However, their associations with the long-term risk of AKI in the general population are uncharacterized. We conducted a prospective cohort study in 10 669 participants of the Atherosclerosis Risk in Communities Study (visit 4, 1996-1998, mean age, 63 years, 56% female, 22% black race) to examine the association of plasma concentrations of hs-cTnT and NTproBNP with the incident hospitalization with AKI. We used multivariable Cox regression analysis to estimate hazard ratios (HRs). During follow-up, 1907 participants had an incident hospitalization with AKI. Participants with higher concentrations of hs-cTnT had a higher risk of hospitalization with AKI in a graded fashion (adjusted HR, 1.88 [95%CI , 1.59-2.21] for ≥14 ng/L, 1.36 [1.18-1.57] for 9-13 ng/L, and 1.16 [1.03-1.30] for 5-8 ng/L compared to <5 ng/L). The graded association was also observed for NTproBNP (HR, 2.27 [1.93-2.68] for ≥272.7 pg/mL, 1.67 [1.45-1.93] for 142.4-272.6 pg/mL, and 1.31 [1.17-1.47] for 64.0-142.3 pg/mL compared to <64.0 pg/mL). The addition of hs-cTnT and NTproBNP to a model with established predictors significantly improved 10-year risk prediction for hospitalization with AKI (Δc-statistic, 0.015 [95%CI, 0.006-0.024]). In middle-aged to older black and white adults in the community, higher concentrations of hs-cTnT and NTproBNP were robustly associated with an increased risk of hospitalization with AKI. These results suggest the usefulness of hs-cTnT and NT-proBNP to identify people at risk of AKI in the general population.
Sections du résumé
BACKGROUND
Cardiac markers such as high-sensitivity cardiac troponin T (hs-cTnT) and N-terminal pro-B natriuretic peptide (NTproBNP) are predictors of developing acute kidney injury (AKI) during hospitalization for surgery or revascularization. However, their associations with the long-term risk of AKI in the general population are uncharacterized.
METHODS
We conducted a prospective cohort study in 10 669 participants of the Atherosclerosis Risk in Communities Study (visit 4, 1996-1998, mean age, 63 years, 56% female, 22% black race) to examine the association of plasma concentrations of hs-cTnT and NTproBNP with the incident hospitalization with AKI. We used multivariable Cox regression analysis to estimate hazard ratios (HRs).
RESULTS
During follow-up, 1907 participants had an incident hospitalization with AKI. Participants with higher concentrations of hs-cTnT had a higher risk of hospitalization with AKI in a graded fashion (adjusted HR, 1.88 [95%CI , 1.59-2.21] for ≥14 ng/L, 1.36 [1.18-1.57] for 9-13 ng/L, and 1.16 [1.03-1.30] for 5-8 ng/L compared to <5 ng/L). The graded association was also observed for NTproBNP (HR, 2.27 [1.93-2.68] for ≥272.7 pg/mL, 1.67 [1.45-1.93] for 142.4-272.6 pg/mL, and 1.31 [1.17-1.47] for 64.0-142.3 pg/mL compared to <64.0 pg/mL). The addition of hs-cTnT and NTproBNP to a model with established predictors significantly improved 10-year risk prediction for hospitalization with AKI (Δc-statistic, 0.015 [95%CI, 0.006-0.024]).
CONCLUSIONS
In middle-aged to older black and white adults in the community, higher concentrations of hs-cTnT and NTproBNP were robustly associated with an increased risk of hospitalization with AKI. These results suggest the usefulness of hs-cTnT and NT-proBNP to identify people at risk of AKI in the general population.
Identifiants
pubmed: 33418586
pii: 6071451
doi: 10.1093/clinchem/hvaa288
pmc: PMC7793230
doi:
Substances chimiques
Biomarkers
0
Peptide Fragments
0
Troponin T
0
pro-brain natriuretic peptide (1-76)
0
Natriuretic Peptide, Brain
114471-18-0
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
298-307Subventions
Organisme : NHLBI NIH HHS
ID : HHSN268201700002I
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268201700004I
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268201700003I
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268201700004C
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL134320
Pays : United States
Organisme : NIDDK NIH HHS
ID : R01 DK089174
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268201700001I
Pays : United States
Organisme : NIDDK NIH HHS
ID : K24 DK106414
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268201700005I
Pays : United States
Informations de copyright
© American Association for Clinical Chemistry 2021. All rights reserved. For permissions, please email: journals.permissions@oup.com.
Références
Clin Chem. 2011 Jun;57(6):891-7
pubmed: 21519038
Eur Heart J. 2012 Sep;33(18):2252-7
pubmed: 22723599
J Clin Med. 2018 Dec 12;7(12):
pubmed: 30545066
J Am Heart Assoc. 2020 Mar 3;9(5):e013560
pubmed: 32114886
Nat Rev Nephrol. 2018 Oct;14(10):607-625
pubmed: 30135570
MMWR Morb Mortal Wkly Rep. 2018 Mar 16;67(10):289-293
pubmed: 29543788
Am Heart J. 2016 Sep;179:151-6
pubmed: 27595690
Eur J Prev Cardiol. 2016 Feb;23(3):291-307
pubmed: 25510863
J Am Soc Nephrol. 2011 Sep;22(9):1748-57
pubmed: 21836143
Herz. 2014 Jun;39(4):507-14
pubmed: 23797372
Clin J Am Soc Nephrol. 2006 Jan;1(1):19-32
pubmed: 17699187
Eur Heart J. 2018 Jul 1;39(25):2412-2419
pubmed: 29579246
Am Heart J. 2015 Jan;169(1):31-8.e3
pubmed: 25497245
Am J Epidemiol. 1989 Apr;129(4):687-702
pubmed: 2646917
Transplant Proc. 2012 Sep;44(7):1999-2001
pubmed: 22974891
J Am Coll Cardiol. 2008 Nov 4;52(19):1527-39
pubmed: 19007588
Clin J Am Soc Nephrol. 2015 Feb 6;10(2):205-14
pubmed: 25605700
BMC Anesthesiol. 2017 Jan 31;17(1):15
pubmed: 28143401
Circulation. 2009 Feb 3;119(4):495-502
pubmed: 19153273
J Am Heart Assoc. 2018 Jan 12;7(2):
pubmed: 29330257
Circulation. 2014 Jun 24;129(25 Suppl 2):S49-73
pubmed: 24222018
Circulation. 2011 Apr 5;123(13):1367-76
pubmed: 21422391
Circulation. 2012 Mar 20;125(11):1347-55
pubmed: 22322531
Am J Nephrol. 2010;31(5):408-18
pubmed: 20375494
Eur Heart J. 2020 Nov 1;41(41):4050-4056
pubmed: 32077940
N Engl J Med. 2012 Jul 5;367(1):20-9
pubmed: 22762315
Circulation. 2015 May 26;131(21):1851-60
pubmed: 25825410
Clin J Am Soc Nephrol. 2015 Jan 7;10(1):147-55
pubmed: 25092601
Kidney Int. 2012 Mar;81(5):442-8
pubmed: 22113526
Pediatrics. 2015 Apr;135(4):e945-56
pubmed: 25755241
Ann Thorac Surg. 2011 Oct;92(4):1539-47
pubmed: 21872837
J Am Soc Nephrol. 2005 Nov;16(11):3365-70
pubmed: 16177006
Am J Kidney Dis. 2015 Apr;65(4):550-8
pubmed: 25446023
Clin Chem. 2015 Feb;61(2):368-78
pubmed: 25451868
J Am Coll Cardiol. 2013 Mar 26;61(12):1240-9
pubmed: 23414791
Adv Chronic Kidney Dis. 2013 Jan;20(1):56-66
pubmed: 23265597
Clin J Am Soc Nephrol. 2008 May;3(3):844-61
pubmed: 18337550
Kidney Int Suppl. 2005 Dec;(99):S57-65
pubmed: 16336578
Am J Epidemiol. 2019 Dec 31;188(12):2146-2155
pubmed: 31063194
Clin J Am Soc Nephrol. 2014 Apr;9(4):682-9
pubmed: 24458075