Abstract 1025: Elevated B-Type Natriuretic Peptide and Cardiac Troponin T Interactively Increased Cardiovascular and All-cause Mortality Risk in Hemodialysis Patients -10 Years Prospective Study
Background: It has been established that elevated plasma B-type natriuretic peptide (BNP) and serum cardiac troponin T (TnT) levels were increasingly associated with future cardiovascular (CV) events, respectively. The aim of the present study was to determine whether combination of BNP and TnT could predict mortality in hemodialysis (HD) patients who are regarded as the highest risk group of CV disease.
Methods: Plasma BNP and serum TnT were measured consecutively in pre-dialysis sample in 500 outer HD patients. These patients were divided into quartiles according to plasma BNP levels; Quartile 1 (Q1): <145 ng/L, Q2: 145–266 ng/L, Q3: 267– 628 ng/L, and Q4: >628 ng/L, and serum TnT levels; Quartile 1 (Q1):< 0.04 ng/mL, Q2: 0.04 – 0.07 ng/mL, Q3: 0.07– 0.13 ng/mL, and Q4: > 0.13ng/mL. They were followed during 10 years.
Results: On Cox analysis, hazard ratio (HR) of elevated BNP levels was 3.93 (95%CI 2.06 –7.52 for Q4 versus Q1) for CV mortality and 3.51 (95%CI 2.18 –5.64 for Q4 versus Q1) for all-cause mortality, respectively (both p<0.0001). Similarly, HR of elevated TnT levels was 4.09 (95%CI 1.69 –9.89 for Q4 vs. Q1, p=0.0007) for CV mortality and 4.58 (95%CI 2.31–9.07 for Q4 vs. Q1, p<0.0001) for all-cause mortality. In the setting of combination of BNP and TnT, the risk of CV mortality was 16.9-fold in highest quartile on both BNP and CRP compared with lowest quartile on both BNP and TnT. Similarly, the risk of all-cause mortality was 21.2-fold (Figure⇓).
Conclusions: The combination of BNP and TnT measurements might be useful for risk stratification of mortality in HD patients because the combination of these variables is more closely related to outcome than either variable alone.