Kidney Week

Abstract: TH-PO932

NT-proBNP as a Predictor of Major Cardiac Events in Renal Recipient Patients

Session Information

• Transplantation: AKI, Cardiovascular, and Metabolic Complications
  November 02, 2017 | Location: Hall H, Morial Convention Center
  Abstract Time: 10:00 AM - 10:00 AM

Category: Transplantation

• 1702 Transplantation: Clinical and Translational

Authors

• Kleine, Carola-Ellen, University Hospital of Bonn, Bonn, Germany

Carola-Ellen Kleine,

• Werberich, Roxana, University Hospital of Bonn, Bonn, Germany

Roxana Werberich,

• Werberich, Louisa, University Hospital of Bonn, Bonn, Germany

Louisa Werberich,

• Boes, Dominik, University Hospital of Bonn, Bonn, Germany

Dominik Boes,

• Hundt, Felix, University Hospital of Bonn, Bonn, Germany

Felix Hundt,

• Woitas, Rainer, University Hospital of Bonn, Bonn, Germany

Rainer Woitas,

Background

Patients on renal replacement therapy have an increased cardiovascular risk. NT-proBNP is an established marker for cardiovascular risk and mortality in the general population. In a small cohort of kidney transplant patient NT-proBNP was significantly higher in patients suffering from major cardiac events (MACE). We aimed to further investigate NT-proBNP as a predictor of MACE in renal transplantation.

Methods

The study cohort consisted of 264 patients that were kidney transplanted between 01/2005-05/2015. MACE was defined as myocardial infarction (ST-segment elevation (STEMI) or non ST-segment elevation (NSTEMI)), stroke, intervention requiring coronary artery disease (CAD) or cardiovascular death. Blood samples were drawn prior to the kidney transplantation.
Mann-Whitney U tests, multivariate Cox regression and Kaplan-Meier survival analysis were performed. Before, age, NT-proBNP, creatinine and C-reactive protein (CRP) were logarithmic transformed.

Results

The cohort consisted of 60.6% male patients, median age was 54 years. Mean observation time lasted for 3.2 years. 17.4 % of the patients suffered of MACE: 74% NSTEMI, each 11% STEMI and CAD and 2% cardiovascular death.
Recipients with preoperative NT-proBNP greater 9057.3 pg/ml (4^th quartile) had a significant greater risk to develop MACE (p<0.05) (Figure 1).
After adjustment to age, sex, diabetes mellitus, preexisting CAD, hypertriglyceridemia, cholesterolemia, peripheral occlusive disease, atrial fibrillation, arterial hypertension, creatinine and CRP, NT-proBNP remained an independent risk factor (HR 3.81, 95% Cl 2.04-7.12, p=0.000).

Conclusion

In our cohort of renal transplant recipients NT-proBNP proved to be an independent predictor of MACE. NT-proBNP level at the time of transplantation may identify patients at greater risk for cardiovascular complications.