Association of NTproBNP and cTnI with outpatient sudden cardiac death in hemodialysis patients: the Choices for Healthy Outcomes in Caring for ESRD (CHOICE) study

Sudden cardiac death (SCD) is the most common etiology of death in hemodialysis patients but not much is known about its risk factors. The goal of our study was to determine the association and risk prediction of SCD by serum N-terminal prohormone of brain natriuretic peptide (NTproBNP) troponin I (...

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Bibliographic Details
Published in:BMC nephrology 2016-02, Vol.17 (18), p.18-18, Article 18
Main Authors: Kruzan, Rachel M, Herzog, Charles A, Wu, Aozhou, Sang, Yingying, Parekh, Rulan S, Matsushita, Kunihiro, Hwang, Seungyoung, Cheng, Alan, Coresh, Josef, Powe, Neil R, Shafi, Tariq
Format: Article
Language:English
Subjects:
Adult
Biomarkers - blood
Care and treatment
Chronic kidney failure
Complications and side effects
Death, Sudden, Cardiac - etiology
Development and progression
Female
Follow-Up Studies
Hemodialysis
Humans
Hypertension
Kidney Failure, Chronic - blood
Kidney Failure, Chronic - therapy
Male
Middle Aged
Natriuretic Peptide, Brain - blood
Nephrology
Peptide Fragments - blood
Proportional Hazards Models
Prospective Studies
Renal Dialysis
Risk Assessment
Risk Factors
Troponin I - blood
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Summary:Sudden cardiac death (SCD) is the most common etiology of death in hemodialysis patients but not much is known about its risk factors. The goal of our study was to determine the association and risk prediction of SCD by serum N-terminal prohormone of brain natriuretic peptide (NTproBNP) troponin I (cTnI) in hemodialysis patients. We measured NTproBNP and cTnI in 503 hemodialysis patients of a national prospective cohort study. We determined their association with SCD using Cox regression, adjusting for demographics, co-morbidities, and clinical factors and risk prediction using C-statistic and Net Reclassification Improvement (NRI). Patients' mean age was 58 years and 54 % were male. During follow-up (median 3.5 years), there were 75 outpatient SCD events. In unadjusted and fully-adjusted models, NTproBNP had a significant association with the risk of SCD. Analyzed as a continuous variable, the risk of SCD increased 27 % with each 2-fold increase in NTproBNP (HR, 1.27 per doubling; 95 % CI, 1.13-1.43; p 7,350 pg/mL) compared with the lowest tertile (
ISSN:1471-2369
1471-2369
DOI:10.1186/s12882-016-0230-x