English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Zendy Open

Presents the pdf analysis as premium feature

PDF Analysis

Insights

Presents the summarisation as premium feature

Summarisation

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the zaia usage as premium feature

ZAIA

Zendy Tools

Zendy Plus

Presents the access of premium content as premium feature

Premium Content

Background  Cardiac troponin T and brain natriuretic peptide ( BNP ) are elevated in >50% of dialysis patients and are associated with poor outcomes. Few data investigated these associations in earlier chronic kidney disease (CKD).    Methods and Results  We studied whether  CKD  modified associations of elevated  BNP , N‐terminal‐pro‐ BNP , high‐sensitivity cardiac troponin T, coronary artery calcification, and left ventricular hypertrophy with all‐cause death and cardiovascular death/events in 3218 multiethnic individuals followed for 12.5 years, and whether biomarkers added prognostic information to traditional cardiovascular risk factors in  CKD . Of the cohort, 279 (9%) had  CKD . There were 296 deaths and 218 cardiovascular deaths/events. Of non‐ CKD  individuals, 7% died and 6% had cardiovascular death/event versus 32% and 30% of  CKD  participants,  P <0.001 for both. The interaction between  BNP  and  CKD  on death was significant ( P =0.01): the adjusted hazard ratio in  CKD  was 2.05, 95%  CI  (1.34, 3.14), but not significant in non‐ CKD , 1.04 (0.76, 1.41).  CKD  modified the association of high‐sensitivity cardiac troponin T with cardiovascular death/event, adjusted hazard ratio 3.34 (1.56, 7.18) in  CKD  versus 1.65 (1.16, 2.35) in non‐ CKD , interaction  P =0.09. There was an interaction between N‐terminal‐pro‐ BNP  and  CKD  for death in those without prior cardiovascular disease. Addition of each biomarker to traditional risk factors improved risk prediction, except coronary artery calcification was not discriminatory for cardiovascular death/event in CKD.    Conclusions  Cardiac biomarkers, with the exception of coronary artery calcification, prognosticated outcomes in early‐stage  CKD  as well as, if not better than, in non‐ CKD  individuals, even after controlling for estimated glomerular filtration rate, and added to information obtained from traditional cardiovascular risk factors alone.

Effect Modification of Chronic Kidney Disease on the Association of Circulating and Imaging Cardiac Biomarkers With Outcomes