BLOOD TEST PREDICTS SOME RISK OF HEART FAILURE
Two blood markers are
strongly linked with the development of heart failure in individuals with mild
to severe kidney disease, according to a study appearing in an upcoming issue
of the Journal of the American
Society of Nephrology (JASN). Elevations in these markers may indicate
subclinical cardiovascular changes that subsequently contribute to the
development of heart failure.
Patients with chronic
kidney disease (CKD) are at increased risk of developing heart failure and
other cardiovascular diseases. Nisha Bansal, MD, MAS (University of Washington)
Amanda Anderson, PhD, MPH (University of Pennsylvania), and their colleagues
conducted a study to see if certain blood tests might help identify patients at
especially high risk. These tests -- which measure proteins called
high-sensitivity troponin T (hsTnT) and N-terminal pro-B-type natriuretic
peptide (NT-proBNP) -- strongly predict heart failure in the general
population, but their predictive utility in patients with CKD is unknown. The
researchers studied 3483 patients with CKD in the Chronic Renal Insufficiency
Cohort (CRIC) Study who were recruited from June 2003 to August 2008 and were
free of heart failure when they enrolled. Patients were followed for a median
of nearly 6 years.
Compared with
participants with the lowest levels of hsTnT at the start of the study, those
with the highest hsTnT levels had a nearly 5-fold higher risk of developing
heart failure. Those with the highest NT-proBNP levels had a nearly 10-fold
higher risk of developing heart failure compared with those with the lowest
levels.
"This research is
important in that it may advance the application of widely available cardiac
biomarkers to identify CKD patients at the highest risk of developing heart
failure, the most common cardiovascular complication in this patient
population," said Dr. Bansal. "These findings suggest that hsTnT and
NT-proBNP may represent distinct biological pathways that likely involve
subclinical changes in the structure and function of the heart," said Dr.
Anderson.
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