Variation of NT-proBNP and High-Sensitivity Cardiac Troponin T Across Levels of Estimated Glomerular Filtration Rate: The SPRINT Trial.
Variation of NT-proBNP and High-Sensitivity Cardiac Troponin T Across Levels of Estimated Glomerular Filtration Rate: The SPRINT Trial.
复制标题
NT-proBNP 和高敏心肌肌钙蛋白 T 随估计肾小球滤过率水平的变化：SPRINT 试验。
DOI：
10.1161/circulationaha.123.066377
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发表时间：
2024
期刊：
影响因子：
37.8
通讯作者：
Ix,JoachimH
中科院分区：
文献类型：
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作者：
Bansal,Nisha;Katz,Ronit;Seliger,Stephen;deFilippi,Christopher;Wettersten,Nicholas;deLemos,JamesA;Christenson,Robert;Killeen,AnthonyA;Berry,JarettD;Shlipak,MichaelG;Ix,JoachimH
NT-proBNP（N末端B型利钠肽前体）和hs-cTnT（高敏心肌肌钙蛋白T）被广泛用于急性心力衰竭和心肌梗死的诊断。慢性肾脏病（CKD）患者急性心力衰竭和急性心肌梗死的风险较高，但即使无症状，他们的hs-cTnT和NT-proBNP水平也可能高于用于指示无CKD患者急性疾病的阈值。1没有解释CKD中心脏生物标志物的阈值。另一种方法是确定每个CKD患者稳定时的NT-proBNP和hs-cTnT基线值，如果患者随后出现提示急性心力衰竭或急性心肌梗死的症状，则可用于比较。该策略要求在无急性疾病的情况下，心脏生物标志物的动态值随时间保持稳定;然而，在CKD各阶段中，NT-proBNP和hs-cTnT随时间的变化仍未知。为了解决这一差距，我们在SPRINT（收缩压干预试验）中检查了不同估计肾小球滤过率（eGFR）水平的心脏生物标志物的年度变化。2
NT-proBNP (N-terminal pro-B-type natriuretic peptide) and hs-cTnT (high-sensitivity cardiac troponin T) are widely used for the diagnosis of acute heart failure and myocardial infarction. Patients with chronic kidney disease (CKD) are at high risk of acute heart failure and acute myocardial infarction, yet even when asymptomatic, they may have levels of hs-cTnT and NT-proBNP that are above thresholds used to indicate acute disease in people without CKD. 1 There are no thresholds to interpret cardiac biomarkers in CKD. An alternative approach could be to identify a baseline value of NT-proBNP and hs-cTnT for each person with CKD when they are stable, which could be used for comparison if the patient presents subsequently with symptoms suggestive of acute heart failure or acute myocardial infarction. This strategy requires that ambulatory values of cardiac biomarkers be stable over time in the absence of acute disease; however, the variation of NT-proBNP and hs-cTnT over time across the stages of CKD remains unknown. To address this gap, we examined the annual variation of cardiac biomarkers across levels of estimated glomerular filtration rate (eGFR) in SPRINT (Systolic Blood Pressure Intervention Trial). 2