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Abstract: TH-PO464

N-Terminal Pro-B-Type Natriuretic Peptide and Cardiac Troponin T for Detection of Left Ventricular Hypertrophy in Non-Dialysis CKD Patients

Session Information

Category: Hypertension and CVD

  • 1401 Hypertension and CVD: Epidemiology, Risk Factors, and Prevention

Authors

  • Zhang, Han, Zhongshan Hospital, Fudan University, Shanghai, China
  • Chen, Jing, Zhongshan Hospital, Fudan University, Shanghai, China
Background

The mortality of cardiovascular disease (CVD) in the patients with chronic kidney disease (CKD) is significantly higher than in the general population. Plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) and cardiac troponin T (cTnT) have been shown to be powerful predictors of cardiovascular mortality. In subjects with albuminuria or impaired renal function, the use of these cardiac biomarkers has been debated. In this cross-section study, we tried to investigate whether these two biomarkers could predict left ventricular hypertrophy (LVH) in subjects with CKD patients and the prediction power of both.

Methods

A total of 1320 pre-dialysis CKD patients were recruited in this study. NT-pro-BNP and cTnT were all measured on the Roche cobas E602 (Roche Diagnostics). Left ventricular mass index (LVMI) were determined by an echocardiographic examination.

Results

Participants in high NT-proBNP group, as well as participants in high cTnT group ,had a worse cardiovascular risk profile and had more LVH. Participants with high cardiac biomarkers had also more often a lower eGFR and higher proteinuria. Multivariable-adjusted association of NT-proBNP level and LVH was OR 1.233(95%CI 1.131 to 1.345) for per 1000pg/ml increase. Multivariable-adjusted association of cTnT level and LVH was OR 1.005(95%CI 1.001 to 1.010)for per 100ng/L increase.Then we identified optimal threshold value for NT-ProBNP and cTnT. The 90th percentile of NT-proBNP had moderately high positive likehood ratios for detecting LVH, 50th percentile of NT-proBNP had moderately low negtive likehood ratios for detecting LVH. The 90th percentile and 50th percentile of cTnT had optimal positive likehood ratios and negtive likehood ratios separately for detecting LVH.

Conclusion

NT-proBNP and cTnT both are independent factors associated with the echocardiographic parameters of LVH in CKD patients. The diagnostic performance of NT-proBNP is significantly superior than cTnT.

Association of NT-proBNP and cTnT with LVH
VariablesNT-proBNP( per 1000pg/ml)cTnT(per 100ng/L)
Demographic-adjusted1.373(1.262-1.495)**1.014(1.009-1.020)**
Multivariate-adjusted1.233(1.131-1.345)**1.005(1.001-1.010)*

Data are presented as OR (95% CI).*P<0.05, **P<0.001. Left ventricular hypertrophy was defined as LVM/height2.7 >47 g/m2.7 for women and >50 g/m2.7 for men.