Multi-biomarker risk stratification of N-terminal pro-B-type natriuretic peptide, high-sensitivity C-reactive protein, and cardiac troponin T and I in end-stage renal disease for all-cause death
Multi-biomarker risk stratification of N-terminal pro-B-type natriuretic peptide, high-sensitivity C-reactive protein, and cardiac troponin T and I in end-stage renal disease for all-cause death
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DOI：
10.1373/clinchem.2004.035741
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发表时间：
2004-12-01
影响因子：
9.3
通讯作者：
Herzog, CA
中科院分区：
文献类型：
--
作者：
Apple, FS;Murakami, MM;Herzog, CA
背景：在终末期肾病（ESRD）患者中，单一和多重生物标志物监测预测不良后果的能力尚未确定。本研究确定了 399 名 ESRD 患者 2 年内多种生物标志物对全因死亡的预后价值。全因死亡风险是通过使用基于参考人群（正常）浓度的多种生物标志物和基于 ESRD 组三分位数分布的截止值来确定的。研究的 Pio 标志物包括 N 末端 B 型利钠肽原 (NT-proBNP)、高敏 C 反应蛋白（hsCRP；Dade Behring 和 Roche 测定）以及心肌肌钙蛋白 T（cTnT；Roche）和 I（cTnI、Dade Behring 和 Beckman Coulter 测定）。估计死亡的相对风险并计算生存曲线。结果：。在 594 患者年的随访期间，共有 101 人死亡。根据正常临界值，NT-proBNP 浓度增加并不能预测死亡。然而，NT-proBNP 的三分位数分析可显着预测死亡，并且曲线下的 ROC 面积等于或优于任何其他生物标志物。独立预测生存的生物标志物是 hsCRP（P
Background: In patients, with end-stage renal disease (ESRD), the ability of single and multiple biomarker monitoring to predict adverse outcomes has not been well established. This study determined the prognostic value of multiple biomarkers for all-cause death over 2 years in 399 ESRD patients.Methods; The risk of all-cause death was determined by use of multiple bionmarkers based on concentrations for a reference population (normal) and cutoffs based on tertile distributions in the ESRD group. Piomarkers studied included N-terminal pro-B-type natriuretic peptide (NT-proBNP), high-sensitivity C-reactive protein (hsCRP; Dade Behring and Roche assays), and cardiac troponin T (cTnT; Roche) and I (cTnI, Dade Behring and Beckman Coulter assays). Relative risks of death were estimated and survival curves computed.Results:. A total of 101 deaths occurred during 594 patient-years of follow-up. Increased NT-proBNP concentrations were not predictive of death on the basis of the normal cutoffs. However, tertile analysis,of NT-proBNP was significantly predictive of death and had a ROC area under the curve equivalent to or better than any of the other biomarkers. Biomarkers independently predictive of survival were hsCRP (P