Original InvestigationPathogenesis and Treatment of Kidney DiseaseAssociation of High-Sensitivity Cardiac Troponin T and Natriuretic Peptide With Incident ESRD: The Atherosclerosis Risk in Communities (ARIC) Study
Section snippets
Study Population
The Atherosclerosis Risk in Communities (ARIC) Study is a prospective cohort of 15,792 individuals aged 45 to 64 years at visit 1 (1987-1989) from 4 US communities (Forsyth County, NC; Jackson, MS; suburban Minneapolis, MN; and Washington County, MD). There were 3 short-term follow-up examinations in 1990 to 1992 (visit 2), 1993 to 1995 (visit 3), and 1996 to 1998 (visit 4). Of 15,792 participants, 11,656 (74%) attended visit 4, at which hs-cTnT and NT-proBNP were measured. For this study, we
Participant Characteristics
Compared with those with lower hs-cTnT levels, individuals with higher hs-cTnT levels were more likely to be older, men, and black and have a generally higher cardiovascular risk profile (eg, higher BMI and blood pressure, higher ACR and NT-proBNP levels, more prevalent diabetes and history of CVD, and lower high-density lipoprotein cholesterol levels and eGFRs; Table 1). Similar patterns were observed among individuals with higher NT-proBNP levels (Table S1, available as online supplementary
Discussion
This study demonstrated that higher hs-cTnT and NT-proBNP levels were associated independently with incident ESRD in the general population. Our results generally are consistent with the previous report from TREAT in which all patients had diabetic nephropathy and anemia.17 We extended the results from TREAT in various aspects. First, we confirmed the associations of hs-cTnT and NT-proBNP levels with ESRD in a population with preserved kidney function, minimizing the concern for reverse
Acknowledgements
The authors thank the staff and participants of the ARIC Study for important contributions.
Some of the data reported here have been supplied by the USRDS. The interpretation and reporting of these data are the responsibility of the authors and in no way should be seen as an official policy or interpretation of the US government.
Support: The ARIC Study is carried out as a collaborative study supported by National Heart, Lung and Blood Institute contracts (HHSN268201100005C, HHSN268201100006C,
References (50)
- et al.
Cardiorenal syndrome
J Am Coll Cardiol
(2008) - et al.
Congestive heart failure in dialysis patients: prevalence, incidence, prognosis and risk factors
Kidney Int
(1995) - et al.
Association between cardiac biomarkers and the development of ESRD in patients with type 2 diabetes mellitus, anemia, and CKD
Am J Kidney Dis
(2011) - et al.
Survival trends in ESRD patients compared with the general population in the United States
Am J Kidney Dis
(2014) - et al.
Cardiorenal interactions: insights from the ESCAPE trial
J Am Coll Cardiol
(2008) - et al.
The role of renin-angiotensin-aldosterone system in the progression of chronic kidney disease
Kidney Int Suppl
(2005) - et al.
Renin-angiotensin system activation and interstitial inflammation in human diabetic nephropathy
Kidney Int Suppl
(2003) - et al.
Associations between retinal microvascular abnormalities and declining renal function in the elderly population: the Cardiovascular Health Study
Am J Kidney Dis
(2005) - et al.
Chronic hyperglycemia and subclinical myocardial injury
J Am Coll Cardiol
(2012) - et al.
Coronary microvascular dysfunction is highly prevalent in women with chest pain in the absence of coronary artery disease: results from the NHLBI WISE Study
Am Heart J
(2001)
Women, cardiac syndrome X, and microvascular heart disease
Can J Cardiol
Troponin elevation in heart failure prevalence, mechanisms, and clinical implications
J Am Coll Cardiol
Developing and assessing cardiovascular biomarkers
Translat Res
Does the relationship between natriuretic hormones and diastolic function differ by race?
Am J Med Sci
Cardiorenal and renocardiac syndromes: the need for a comprehensive classification and consensus
Nat Clin Pract Nephrol
Kidney-heart interactions: epidemiology, pathogenesis, and treatment
Clin J Am Soc Nephrol
Cardiorenal syndrome: new perspectives
Circulation
Oxidative stress in the cardiorenal metabolic syndrome
Curr Hypertens Rep
Inflammatory activation: cardiac, renal, and cardio-renal interactions in patients with the cardiorenal syndrome
Heart Fail Rev
Molecular pathways and crosstalk characterizing the cardiorenal syndrome
OMICS
Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization
N Engl J Med
Association of estimated glomerular filtration rate and albuminuria with all-cause and cardiovascular mortality in general population cohorts: a collaborative meta-analysis
Lancet
Renal insufficiency and heart failure: prognostic and therapeutic implications from a prospective cohort study
Circulation
Is left ventricular hypertrophy a powerful predictor of progression to dialysis in chronic kidney disease?
Nephrol Dial Transplant
Kidney disease as a risk factor for development of cardiovascular disease: a statement from the American Heart Association Councils on Kidney in Cardiovascular Disease, High Blood Pressure Research, Clinical Cardiology, and Epidemiology and Prevention
Circulation
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