Comparison of the Association Between High-Sensitivity Troponin I and Adverse Cardiovascular Outcomes in Patients With Versus Without Chronic Kidney Disease
It is unknown whether the association of high-sensitivity troponin I (hs-TnI) with adverse cardiovascular outcomes varies by the presence of chronic kidney disease (CKD). We examined the association of hs-TnI with adverse cardiovascular outcomes in those with and without CKD in 4,107 (mean age, 64 y...
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| Veröffentlicht in: | The American journal of cardiology 2018-06, Vol.121 (12), p.1461-1466 |
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| creator | Sandesara, Pratik B. O'Neal, Wesley T. Tahhan, Ayman Samman Hayek, Salim S. Lee, Suegene K. Khambhati, Jay Topel, Matthew L. Hammadah, Muhammad Alkhoder, Ayman Ko, Yi-An Gafeer, Mohamad Mazen Beshiri, Agim Murtagh, Gillian Kim, Jonathan H. Wilson, Peter Shaw, Leslee Epstein, Stephen E. Sperling, Laurence S. Quyyumi, Arshed A. |
| description | It is unknown whether the association of high-sensitivity troponin I (hs-TnI) with adverse cardiovascular outcomes varies by the presence of chronic kidney disease (CKD). We examined the association of hs-TnI with adverse cardiovascular outcomes in those with and without CKD in 4,107 (mean age, 64 years; 63% men; 20% black) patients from the Emory Cardiovascular Biobank who underwent coronary angiography. CKD (n = 1,073) was defined as estimated glomerular filtration rate 30 mg/g at baseline. Cox regression was used to compute hazard ratios (HR) for the association between hs-TnI levels (per doubling of hs-TnI: log2[hs-TnI] + 1) and death, cardiovascular death, and major adverse cardiac events (MACE), separately. Hs-TnI was a stronger predictor of death (CKD: HR 1.23, 95% confidence interval [CI] 1.15 to 1.31; no CKD: HR 1.11, 95% CI 1.05 to 1.17, p-interaction = 0.023), cardiovascular death (CKD: HR 1.24, 95% CI 1.14 to 1.34; no CKD: HR 1.15, 95% CI 1.07 to 1.22, p-interaction = 0.12), and MACE (CKD: HR 1.18, 95% CI 1.11 to 1.25; no CKD: HR 1.11, 95% CI 1.06 to 1.16, p-interaction = 0.095) in CKD compared with non-CKD. The association between hs-TnI and death in patients with CKD was stronger for patients without obstructive coronary artery disease (no obstructive coronary artery disease: HR 1.60, 95% CI 1.27 to 2.01; obstructive coronary artery disease: HR 1.19, 95% CI 1.11 to 1.27, p-interaction = 0.041). In conclusion, hs-TnI is a stronger predictor of adverse cardiovascular events in patients who have CKD than those without, even in the absence of obstructive coronary artery disease. Hs-TnI may identify CKD patients who are high risk for adverse cardiovascular outcomes in whom aggressive risk factor modification strategies are warranted. |
| doi_str_mv | 10.1016/j.amjcard.2018.02.039 |
| format | Article |
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We examined the association of hs-TnI with adverse cardiovascular outcomes in those with and without CKD in 4,107 (mean age, 64 years; 63% men; 20% black) patients from the Emory Cardiovascular Biobank who underwent coronary angiography. CKD (n = 1,073) was defined as estimated glomerular filtration rate <60 ml/min/1.73 m2 or urine albumin/creatinine ratio >30 mg/g at baseline. Cox regression was used to compute hazard ratios (HR) for the association between hs-TnI levels (per doubling of hs-TnI: log2[hs-TnI] + 1) and death, cardiovascular death, and major adverse cardiac events (MACE), separately. Hs-TnI was a stronger predictor of death (CKD: HR 1.23, 95% confidence interval [CI] 1.15 to 1.31; no CKD: HR 1.11, 95% CI 1.05 to 1.17, p-interaction = 0.023), cardiovascular death (CKD: HR 1.24, 95% CI 1.14 to 1.34; no CKD: HR 1.15, 95% CI 1.07 to 1.22, p-interaction = 0.12), and MACE (CKD: HR 1.18, 95% CI 1.11 to 1.25; no CKD: HR 1.11, 95% CI 1.06 to 1.16, p-interaction = 0.095) in CKD compared with non-CKD. The association between hs-TnI and death in patients with CKD was stronger for patients without obstructive coronary artery disease (no obstructive coronary artery disease: HR 1.60, 95% CI 1.27 to 2.01; obstructive coronary artery disease: HR 1.19, 95% CI 1.11 to 1.27, p-interaction = 0.041). In conclusion, hs-TnI is a stronger predictor of adverse cardiovascular events in patients who have CKD than those without, even in the absence of obstructive coronary artery disease. Hs-TnI may identify CKD patients who are high risk for adverse cardiovascular outcomes in whom aggressive risk factor modification strategies are warranted.</description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/j.amjcard.2018.02.039</identifier><identifier>PMID: 29628129</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aged ; Aged, 80 and over ; Angiography ; Body mass index ; Calcium-binding protein ; Cardiovascular disease ; Cardiovascular diseases ; Cardiovascular Diseases - mortality ; Case-Control Studies ; Cause of Death ; Confidence intervals ; Coronary artery ; Coronary artery disease ; Coronary Artery Disease - blood ; Coronary Artery Disease - epidemiology ; Coronary vessels ; Creatinine ; Death ; Diabetes ; Electrocardiography ; Enzymes ; Family medical history ; Female ; Gender ; Glomerular filtration rate ; Health risks ; Heart attacks ; Heart diseases ; Heart failure ; Humans ; Hypertension ; Intubation ; Kidney diseases ; Kidneys ; Male ; Medical records ; Middle Aged ; Mortality ; Myocardial Infarction - epidemiology ; Myocardial Revascularization - statistics & numerical data ; Patients ; Prognosis ; Proportional Hazards Models ; Proteins ; Renal Insufficiency, Chronic - blood ; Renal Insufficiency, Chronic - epidemiology ; Risk factors ; Sensitivity ; Statistical analysis ; Troponin ; Troponin I ; Troponin I - blood ; United States - epidemiology ; Urine</subject><ispartof>The American journal of cardiology, 2018-06, Vol.121 (12), p.1461-1466</ispartof><rights>2018 Elsevier Inc.</rights><rights>Copyright © 2018 Elsevier Inc. All rights reserved.</rights><rights>2018. Elsevier Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c393t-42fb3ea6ec7d6d376ba660c66924998acdfc7dd7406a5a85f7ce6f6a07436df53</citedby><cites>FETCH-LOGICAL-c393t-42fb3ea6ec7d6d376ba660c66924998acdfc7dd7406a5a85f7ce6f6a07436df53</cites><orcidid>0000-0002-2809-8789</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0002914918302753$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65534</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29628129$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sandesara, Pratik B.</creatorcontrib><creatorcontrib>O'Neal, Wesley T.</creatorcontrib><creatorcontrib>Tahhan, Ayman Samman</creatorcontrib><creatorcontrib>Hayek, Salim S.</creatorcontrib><creatorcontrib>Lee, Suegene K.</creatorcontrib><creatorcontrib>Khambhati, Jay</creatorcontrib><creatorcontrib>Topel, Matthew L.</creatorcontrib><creatorcontrib>Hammadah, Muhammad</creatorcontrib><creatorcontrib>Alkhoder, Ayman</creatorcontrib><creatorcontrib>Ko, Yi-An</creatorcontrib><creatorcontrib>Gafeer, Mohamad Mazen</creatorcontrib><creatorcontrib>Beshiri, Agim</creatorcontrib><creatorcontrib>Murtagh, Gillian</creatorcontrib><creatorcontrib>Kim, Jonathan H.</creatorcontrib><creatorcontrib>Wilson, Peter</creatorcontrib><creatorcontrib>Shaw, Leslee</creatorcontrib><creatorcontrib>Epstein, Stephen E.</creatorcontrib><creatorcontrib>Sperling, Laurence S.</creatorcontrib><creatorcontrib>Quyyumi, Arshed A.</creatorcontrib><title>Comparison of the Association Between High-Sensitivity Troponin I and Adverse Cardiovascular Outcomes in Patients With Versus Without Chronic Kidney Disease</title><title>The American journal of cardiology</title><addtitle>Am J Cardiol</addtitle><description>It is unknown whether the association of high-sensitivity troponin I (hs-TnI) with adverse cardiovascular outcomes varies by the presence of chronic kidney disease (CKD). We examined the association of hs-TnI with adverse cardiovascular outcomes in those with and without CKD in 4,107 (mean age, 64 years; 63% men; 20% black) patients from the Emory Cardiovascular Biobank who underwent coronary angiography. CKD (n = 1,073) was defined as estimated glomerular filtration rate <60 ml/min/1.73 m2 or urine albumin/creatinine ratio >30 mg/g at baseline. Cox regression was used to compute hazard ratios (HR) for the association between hs-TnI levels (per doubling of hs-TnI: log2[hs-TnI] + 1) and death, cardiovascular death, and major adverse cardiac events (MACE), separately. Hs-TnI was a stronger predictor of death (CKD: HR 1.23, 95% confidence interval [CI] 1.15 to 1.31; no CKD: HR 1.11, 95% CI 1.05 to 1.17, p-interaction = 0.023), cardiovascular death (CKD: HR 1.24, 95% CI 1.14 to 1.34; no CKD: HR 1.15, 95% CI 1.07 to 1.22, p-interaction = 0.12), and MACE (CKD: HR 1.18, 95% CI 1.11 to 1.25; no CKD: HR 1.11, 95% CI 1.06 to 1.16, p-interaction = 0.095) in CKD compared with non-CKD. The association between hs-TnI and death in patients with CKD was stronger for patients without obstructive coronary artery disease (no obstructive coronary artery disease: HR 1.60, 95% CI 1.27 to 2.01; obstructive coronary artery disease: HR 1.19, 95% CI 1.11 to 1.27, p-interaction = 0.041). In conclusion, hs-TnI is a stronger predictor of adverse cardiovascular events in patients who have CKD than those without, even in the absence of obstructive coronary artery disease. Hs-TnI may identify CKD patients who are high risk for adverse cardiovascular outcomes in whom aggressive risk factor modification strategies are warranted.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Angiography</subject><subject>Body mass index</subject><subject>Calcium-binding protein</subject><subject>Cardiovascular disease</subject><subject>Cardiovascular diseases</subject><subject>Cardiovascular Diseases - mortality</subject><subject>Case-Control Studies</subject><subject>Cause of Death</subject><subject>Confidence intervals</subject><subject>Coronary artery</subject><subject>Coronary artery disease</subject><subject>Coronary Artery Disease - blood</subject><subject>Coronary Artery Disease - epidemiology</subject><subject>Coronary vessels</subject><subject>Creatinine</subject><subject>Death</subject><subject>Diabetes</subject><subject>Electrocardiography</subject><subject>Enzymes</subject><subject>Family medical history</subject><subject>Female</subject><subject>Gender</subject><subject>Glomerular filtration rate</subject><subject>Health risks</subject><subject>Heart attacks</subject><subject>Heart diseases</subject><subject>Heart failure</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Intubation</subject><subject>Kidney diseases</subject><subject>Kidneys</subject><subject>Male</subject><subject>Medical records</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Myocardial Infarction - epidemiology</subject><subject>Myocardial Revascularization - statistics & numerical data</subject><subject>Patients</subject><subject>Prognosis</subject><subject>Proportional Hazards Models</subject><subject>Proteins</subject><subject>Renal Insufficiency, Chronic - blood</subject><subject>Renal Insufficiency, Chronic - epidemiology</subject><subject>Risk factors</subject><subject>Sensitivity</subject><subject>Statistical analysis</subject><subject>Troponin</subject><subject>Troponin I</subject><subject>Troponin I - blood</subject><subject>United States - epidemiology</subject><subject>Urine</subject><issn>0002-9149</issn><issn>1879-1913</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkctuEzEUhi0EomnhEUCW2LCZwZcZz3iFwlBoRaUiUWBpOfYZ4ihjp7YnKO_Cw-IqgQUbVr595_fR-RB6QUlNCRVvNrWeNkZHWzNC-5qwmnD5CC1o38mKSsofowUhhFWSNvIMnae0KUdKW_EUnTEpWE-ZXKBfQ5h2OroUPA4jzmvAy5SCcTq7cvUO8k8Aj6_cj3X1BXxy2e1dPuC7GHbBO4-vsfYWL-0eYgI8lIZc2Otk5q2O-HbOJkyQcAE_l0TwOeHvLq_xt4LPx32YMx7WsaQZ_MlZDwf83iXQCZ6hJ6PeJnh-Wi_Q1w-Xd8NVdXP78XpY3lSGS56rho0rDlqA6aywvBMrLQQxQkjWSNlrY8fyYruGCN3qvh07A2IUmnQNF3Zs-QV6fczdxXA_Q8pqcsnAdqs9hDkpRhhvSC9kV9BX_6CbMEdfuitUwzvSNB0tVHukTAwpRRjVLrpJx4OiRD3oUxt10qce9CnCVNFX6l6e0ufVBPZv1R9fBXh7BKCMY-8gqmTKVA1YF8FkZYP7zxe_ARFrsNs</recordid><startdate>20180615</startdate><enddate>20180615</enddate><creator>Sandesara, Pratik B.</creator><creator>O'Neal, Wesley T.</creator><creator>Tahhan, Ayman Samman</creator><creator>Hayek, Salim S.</creator><creator>Lee, Suegene K.</creator><creator>Khambhati, Jay</creator><creator>Topel, Matthew L.</creator><creator>Hammadah, Muhammad</creator><creator>Alkhoder, Ayman</creator><creator>Ko, Yi-An</creator><creator>Gafeer, Mohamad Mazen</creator><creator>Beshiri, Agim</creator><creator>Murtagh, Gillian</creator><creator>Kim, Jonathan H.</creator><creator>Wilson, Peter</creator><creator>Shaw, Leslee</creator><creator>Epstein, Stephen E.</creator><creator>Sperling, Laurence S.</creator><creator>Quyyumi, Arshed A.</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>M7Z</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-2809-8789</orcidid></search><sort><creationdate>20180615</creationdate><title>Comparison of the Association Between High-Sensitivity Troponin I and Adverse Cardiovascular Outcomes in Patients With Versus Without Chronic Kidney Disease</title><author>Sandesara, Pratik B. ; O'Neal, Wesley T. ; Tahhan, Ayman Samman ; Hayek, Salim S. ; Lee, Suegene K. ; Khambhati, Jay ; Topel, Matthew L. ; Hammadah, Muhammad ; Alkhoder, Ayman ; Ko, Yi-An ; Gafeer, Mohamad Mazen ; Beshiri, Agim ; Murtagh, Gillian ; Kim, Jonathan H. ; Wilson, Peter ; Shaw, Leslee ; Epstein, Stephen E. ; Sperling, Laurence S. ; Quyyumi, Arshed A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c393t-42fb3ea6ec7d6d376ba660c66924998acdfc7dd7406a5a85f7ce6f6a07436df53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Angiography</topic><topic>Body mass index</topic><topic>Calcium-binding protein</topic><topic>Cardiovascular disease</topic><topic>Cardiovascular diseases</topic><topic>Cardiovascular Diseases - mortality</topic><topic>Case-Control Studies</topic><topic>Cause of Death</topic><topic>Confidence intervals</topic><topic>Coronary artery</topic><topic>Coronary artery disease</topic><topic>Coronary Artery Disease - blood</topic><topic>Coronary Artery Disease - epidemiology</topic><topic>Coronary vessels</topic><topic>Creatinine</topic><topic>Death</topic><topic>Diabetes</topic><topic>Electrocardiography</topic><topic>Enzymes</topic><topic>Family medical history</topic><topic>Female</topic><topic>Gender</topic><topic>Glomerular filtration rate</topic><topic>Health risks</topic><topic>Heart attacks</topic><topic>Heart diseases</topic><topic>Heart failure</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Intubation</topic><topic>Kidney diseases</topic><topic>Kidneys</topic><topic>Male</topic><topic>Medical records</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Myocardial Infarction - epidemiology</topic><topic>Myocardial Revascularization - statistics & numerical data</topic><topic>Patients</topic><topic>Prognosis</topic><topic>Proportional Hazards Models</topic><topic>Proteins</topic><topic>Renal Insufficiency, Chronic - blood</topic><topic>Renal Insufficiency, Chronic - epidemiology</topic><topic>Risk factors</topic><topic>Sensitivity</topic><topic>Statistical analysis</topic><topic>Troponin</topic><topic>Troponin I</topic><topic>Troponin I - blood</topic><topic>United States - epidemiology</topic><topic>Urine</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sandesara, Pratik B.</creatorcontrib><creatorcontrib>O'Neal, Wesley T.</creatorcontrib><creatorcontrib>Tahhan, Ayman Samman</creatorcontrib><creatorcontrib>Hayek, Salim S.</creatorcontrib><creatorcontrib>Lee, Suegene K.</creatorcontrib><creatorcontrib>Khambhati, Jay</creatorcontrib><creatorcontrib>Topel, Matthew L.</creatorcontrib><creatorcontrib>Hammadah, Muhammad</creatorcontrib><creatorcontrib>Alkhoder, Ayman</creatorcontrib><creatorcontrib>Ko, Yi-An</creatorcontrib><creatorcontrib>Gafeer, Mohamad Mazen</creatorcontrib><creatorcontrib>Beshiri, Agim</creatorcontrib><creatorcontrib>Murtagh, Gillian</creatorcontrib><creatorcontrib>Kim, Jonathan H.</creatorcontrib><creatorcontrib>Wilson, Peter</creatorcontrib><creatorcontrib>Shaw, Leslee</creatorcontrib><creatorcontrib>Epstein, Stephen E.</creatorcontrib><creatorcontrib>Sperling, Laurence S.</creatorcontrib><creatorcontrib>Quyyumi, Arshed A.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Physical Education Index</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Biochemistry Abstracts 1</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sandesara, Pratik B.</au><au>O'Neal, Wesley T.</au><au>Tahhan, Ayman Samman</au><au>Hayek, Salim S.</au><au>Lee, Suegene K.</au><au>Khambhati, Jay</au><au>Topel, Matthew L.</au><au>Hammadah, Muhammad</au><au>Alkhoder, Ayman</au><au>Ko, Yi-An</au><au>Gafeer, Mohamad Mazen</au><au>Beshiri, Agim</au><au>Murtagh, Gillian</au><au>Kim, Jonathan H.</au><au>Wilson, Peter</au><au>Shaw, Leslee</au><au>Epstein, Stephen E.</au><au>Sperling, Laurence S.</au><au>Quyyumi, Arshed A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparison of the Association Between High-Sensitivity Troponin I and Adverse Cardiovascular Outcomes in Patients With Versus Without Chronic Kidney Disease</atitle><jtitle>The American journal of cardiology</jtitle><addtitle>Am J Cardiol</addtitle><date>2018-06-15</date><risdate>2018</risdate><volume>121</volume><issue>12</issue><spage>1461</spage><epage>1466</epage><pages>1461-1466</pages><issn>0002-9149</issn><eissn>1879-1913</eissn><abstract>It is unknown whether the association of high-sensitivity troponin I (hs-TnI) with adverse cardiovascular outcomes varies by the presence of chronic kidney disease (CKD). We examined the association of hs-TnI with adverse cardiovascular outcomes in those with and without CKD in 4,107 (mean age, 64 years; 63% men; 20% black) patients from the Emory Cardiovascular Biobank who underwent coronary angiography. CKD (n = 1,073) was defined as estimated glomerular filtration rate <60 ml/min/1.73 m2 or urine albumin/creatinine ratio >30 mg/g at baseline. Cox regression was used to compute hazard ratios (HR) for the association between hs-TnI levels (per doubling of hs-TnI: log2[hs-TnI] + 1) and death, cardiovascular death, and major adverse cardiac events (MACE), separately. Hs-TnI was a stronger predictor of death (CKD: HR 1.23, 95% confidence interval [CI] 1.15 to 1.31; no CKD: HR 1.11, 95% CI 1.05 to 1.17, p-interaction = 0.023), cardiovascular death (CKD: HR 1.24, 95% CI 1.14 to 1.34; no CKD: HR 1.15, 95% CI 1.07 to 1.22, p-interaction = 0.12), and MACE (CKD: HR 1.18, 95% CI 1.11 to 1.25; no CKD: HR 1.11, 95% CI 1.06 to 1.16, p-interaction = 0.095) in CKD compared with non-CKD. The association between hs-TnI and death in patients with CKD was stronger for patients without obstructive coronary artery disease (no obstructive coronary artery disease: HR 1.60, 95% CI 1.27 to 2.01; obstructive coronary artery disease: HR 1.19, 95% CI 1.11 to 1.27, p-interaction = 0.041). In conclusion, hs-TnI is a stronger predictor of adverse cardiovascular events in patients who have CKD than those without, even in the absence of obstructive coronary artery disease. Hs-TnI may identify CKD patients who are high risk for adverse cardiovascular outcomes in whom aggressive risk factor modification strategies are warranted.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>29628129</pmid><doi>10.1016/j.amjcard.2018.02.039</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0002-2809-8789</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0002-9149 |
| ispartof | The American journal of cardiology, 2018-06, Vol.121 (12), p.1461-1466 |
| issn | 0002-9149 1879-1913 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2023408697 |
| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Aged Aged, 80 and over Angiography Body mass index Calcium-binding protein Cardiovascular disease Cardiovascular diseases Cardiovascular Diseases - mortality Case-Control Studies Cause of Death Confidence intervals Coronary artery Coronary artery disease Coronary Artery Disease - blood Coronary Artery Disease - epidemiology Coronary vessels Creatinine Death Diabetes Electrocardiography Enzymes Family medical history Female Gender Glomerular filtration rate Health risks Heart attacks Heart diseases Heart failure Humans Hypertension Intubation Kidney diseases Kidneys Male Medical records Middle Aged Mortality Myocardial Infarction - epidemiology Myocardial Revascularization - statistics & numerical data Patients Prognosis Proportional Hazards Models Proteins Renal Insufficiency, Chronic - blood Renal Insufficiency, Chronic - epidemiology Risk factors Sensitivity Statistical analysis Troponin Troponin I Troponin I - blood United States - epidemiology Urine |
| title | Comparison of the Association Between High-Sensitivity Troponin I and Adverse Cardiovascular Outcomes in Patients With Versus Without Chronic Kidney Disease |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-15T02%3A30%3A28IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Comparison%20of%20the%20Association%20Between%20High-Sensitivity%20Troponin%20I%20and%20Adverse%20Cardiovascular%20Outcomes%20in%20Patients%20With%20Versus%20Without%20Chronic%20Kidney%20Disease&rft.jtitle=The%20American%20journal%20of%20cardiology&rft.au=Sandesara,%20Pratik%20B.&rft.date=2018-06-15&rft.volume=121&rft.issue=12&rft.spage=1461&rft.epage=1466&rft.pages=1461-1466&rft.issn=0002-9149&rft.eissn=1879-1913&rft_id=info:doi/10.1016/j.amjcard.2018.02.039&rft_dat=%3Cproquest_cross%3E2043704471%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2043704471&rft_id=info:pmid/29628129&rft_els_id=S0002914918302753&rfr_iscdi=true |