Prognostic value of highly sensitive troponin T on cardiac events in patients with chronic kidney disease not on dialysis
Prognostic value of highly sensitive troponin T on cardiac events in patients with chronic kidney disease not on dialysis
复制标题
高敏肌钙蛋白 T 对非透析慢性肾病患者心脏事件的预后价值
DOI：
10.1007/s00380-012-0273-2
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发表时间：
2013
影响因子：
1.5
通讯作者：
Y. Yuzawa
中科院分区：
文献类型：
--
作者：
M. Hasegawa;Junichi Ishii;F. Kitagawa;Kyoko Kanayama;Hiroshi Takahashi;Y. Ozaki;Y. Yuzawa
尚未对未接受透析的慢性肾脏病（CKD）患者使用高灵敏度测定法（hsTnT）检测血清肌钙蛋白T水平。这项前瞻性队列研究的目的是调查hsTnT与非透析的非卧床CKD患者心脏事件的相关性。测量了442名未接受透析的非卧床CKD患者的血清hsTnT水平，这些患者的估计肾小球滤过率<60 ml/min/1.73 m2。根据hsTnT水平将患者分为四分位数，并随访3年。心脏事件定义为心源性死亡、急性心肌梗死、需要紧急冠状动脉血运重建的不稳定型心绞痛或因心力衰竭恶化住院。在随访期间（中位数22个月），发生了63起心脏事件。hsTnT水平四分位数间3年心脏事件的Kaplan-Meier发生率分别为0.88%、11.5%、19.0%和41.4%（P < 0.0001）。校正其他混杂因素后，hsTnT水平升高是心脏事件的独立预测因子（风险比6.18，95%置信区间1.38-27.7，最高四分位数vs最低四分位数P = 0.0080）。此外，在已建立的风险加hsTnT模型中，心脏事件的受试者工作特征曲线的C指数大于已建立的单独风险模型（0.857 vs 0.844，P = 0.026）。使用高灵敏度的检测，血清hsTnT水平被证明是一个独立的预测心脏事件和一个有前途的风险分层工具，在CKD患者不透析。
Serum troponin T levels using a highly sensitive assay (hsTnT) in patients with chronic kidney disease (CKD) not on dialysis have not been examined. The aim of this prospective cohort study was to investigate the association of hsTnT with cardiac events in ambulatory CKD patients not on dialysis. The serum hsTnT level was measured in 442 ambulatory CKD patients not on dialysis whose estimated glomerular filtration rate was <60 ml/min/1.73 m2. Patients were divided into quartiles according to hsTnT levels, and were followed up for 3 years. Cardiac events were defined as a cardiac death, acute myocardial infarction, unstable angina pectoris that required emergency coronary revascularization, or hospitalization for worsening heart failure. During the follow-up period (median 22 months), 63 cardiac events occurred. Kaplan–Meier incidence rates of cardiac events for 3 years were 0.88 %, 11.5 %, 19.0 %, and 41.4 % among quartiles of hsTnT levels (P < 0.0001). After adjusting for other confounders, elevated hsTnT level was an independent predictor for cardiac events (hazard ratio 6.18, 95 % confidence interval 1.38–27.7, P = 0.0080 for highest quartile vs lowest quartile). In addition, C-index for receiver-operating characteristic curves for cardiac events was greater in an established risks plus hsTnT model than in the established risk alone model (0.857 vs 0.844, P = 0.026). Using a highly sensitive assay, serum hsTnT level was shown to be an independent predictor of cardiac events and a promising risk stratification tool in patients with CKD not on dialysis.
DOI：
10.1056/nejmoa0805299
发表时间：
2009-12-24
期刊：
The New England journal of medicine
影响因子：
--
作者：
Omland T;de Lemos JA;Sabatine MS;Christophi CA;Rice MM;Jablonski KA;Tjora S;Domanski MJ;Gersh BJ;Rouleau JL;Pfeffer MA;Braunwald E;Prevention of Events with Angiotensin Converting Enzyme Inhibition (PEACE) Trial Investigators
通讯作者：
Prevention of Events with Angiotensin Converting Enzyme Inhibition (PEACE) Trial Investigators
DOI：
10.1001/jama.2010.1768
发表时间：
2010-12-08
期刊：
JAMA
影响因子：
--
作者：
de Lemos JA;Drazner MH;Omland T;Ayers CR;Khera A;Rohatgi A;Hashim I;Berry JD;Das SR;Morrow DA;McGuire DK
通讯作者：
McGuire DK
影响因子：
120.7
作者：
deFilippi, Christopher R.;de Lemos, James A.;Christenson, Robert H.;Gottdiener, John S.;Kop, Willem J.;Zhan, Min;Seliger, Stephen L.
通讯作者：
Seliger, Stephen L.