Abstract: SA-PO920
Comparison of Heart-Type Fatty Acid Binding Protein with Troponin T for Prediction of Cardiovascular Events in the German CKD Study
Session Information
- CKD: Clinical, Outcomes, Trials - III
November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2102 CKD (Non-Dialysis): Clinical, Outcomes, and Trials
Authors
- Schneider, Markus P., Klinikum Nuremberg, Nuremberg, Bavaria, Germany
- Wanner, Christoph, University Hospital Wurzburg, Wuerzburg, Bavaria, Germany
- Krane, Vera, University Hospital Wurzburg, Wuerzburg, Bavaria, Germany
- Floege, Jürgen, RWTH University of Aachen, Aachen, Germany
- Saritas, Turgay, RWTH University of Aachen, Aachen, Germany
- Busch, Martin, University Hospital Jena, Jena, Germany
- Stockmann, Helena, Charité – Universitätsmedizin Berlin, Berlin, Germany
- Meiselbach, Heike, Universitätsklinikum Erlangen, Erlangen, Bavaria, Germany
- Kronenberg, Florian, Innsbruck Medical University, Innsbruck, Tirol, Austria
- Eckardt, Kai-Uwe, Charité – Universitätsmedizin Berlin, Berlin, Germany
Background
Measurement of heart-type fatty acid binding protein (H-FABP) is more sensitive than high-sensitive troponin T (hs-TNT) in the early detection of myocardial injury. H-FABP also improves prediction of long-term cardiovascular (CV) outcomes in patients with acute coronary syndrome. We have investigated the ability of H-FABP in comparison with hs-TNT to predict all-cause mortality and long-term CV outcomes in patients with CKD.
Methods
H-FABP (ELISA, Hycult biotech) and hs-TNT (Cobas system) levels were measured from baseline samples of patients enrolled into the German Chronic Kidney Disease (GCKD) study (n=5127). The associations of H-FABP and hs-TNT with all-cause death, CV death, combined major adverse cardiovascular events (MACE) and hospitalization for heart failure were evaluated by cox regression analyses adjusted for demographics, estimated glomerular filtration rate, urinary albumin excretion rate, CV risk factors, use of statins and renin angiotensin inhibitors. Cardiac structure was examined by magnetic resonance imaging (MRI) in a subgroup of 290 patients.
Results
Both H-FABP and hs-TNT levels were inversely related with renal function. Over a follow-up period of 4 years, there were 345 deaths, 117 CV deaths, 329 MACE and 224 patients were admitted for heart failure. The hazard ratios (HRs) for prediction of these events were greater with hs-TNT than with H-FABP. When both markers were entered simultaneously, only hs-TNT remained a significant predictor in each of the models (e.g. HR for CV death for 1SD increase on the log10 scale: 1.96 (CI 95% 1.54-2.40) for hs-TNT and 0.88 (CI 95% 0.65-1.20) for H-FABP). In the subgroup with MRI measurements, only hs-TNT was related with left ventricular hypertrophy and concentricity (both P<0.001).
Conclusion
In this large prospective cohort of CKD patients, hs-TNT clearly outperformed H-FABP in the prediction of all-cause mortality and CV outcomes. As a potential explanation for these findings, only hs-TNT was associated with altered cardiac structure in a deep-phenotyped subgroup of CKD patients.
Funding
- Commercial Support –