Abstract 12359: Interaction of B-Type Natriuretic Peptide and Cardiac Troponin T Improves the Prediction of Mortality in Patients on Hemodialysis
Background: Patients on hemodialysis (HD) are considered to have a high risk for cardiovascular diseases (CVD). Thus, risk stratification for future events is clinically important in such populations. On the other hand, increased plasma B-type natriuretic peptide (BNP) and serum cardiac troponin T (TnT) levels are highly prevalent in HD patients. We investigated whether a combination of BNP and TnT could improve predictive values for mortality in HD patients.
Methods: The study included 516 stable HD patients who followed up for 10 years. The patients were divided into tertiles according to plasma BNP levels; [tertile 1 (T1): <184 pg/ml, T2: 184-463 pg/ml, and T3: >463 pg/ml] and according to serum TnT levels; [T1: <0.05 ng/ml, T2: 0.05-0.10 ng/ml, and T3: >0.10 ng/ml].
Results: A close correlation was observed between the logarithmic values of BNP and TnT levels (r = 0.41, p < 0.0001). At the 10-year follow-up, Kaplan-Meier survival rates were 73.8%, 60.6%, and 40.1% in T1, T2, and T3 of BNP, respectively, and 82.7%, 54.6%, and 36.2% in T1, T2, and T3 of TnT, respectively (p < 0.0001 in both). In the combined setting of BNP and TnT, the risk of mortality was 5.04-fold (95%CI 2.61-9.74) higher in T3 of both BNP and TnT than that in T1 of both (p < 0.0001). Similar results were obtained from CVD mortality. C-index also showed that adding both BNP and TnT significantly increased prognostic values for all-cause and CVD mortality (Table).
Conclusions: Plasma BNP and serum TnT levels were closely correlated, and they were interactively associated with increasing risk of mortality in HD patients. Furthermore, the combination of BNP and TnT could more accurately predict mortality than either variable alone in C-statistics.
- © 2012 by American Heart Association, Inc.