[Cardiac markers in different degrees of chronic kidney disease: influence of inflammation and previous heart disease]

Med Clin (Barc). 2012 Jun 30;139(3):98-102. doi: 10.1016/j.medcli.2011.05.014. Epub 2011 Jul 31.
[Article in Spanish]

Abstract

Background and objective: Troponin T (TnT), brain natriuretic peptide (BNP) and its precursor (NT-proBNP) are useful markers of acute coronary events and heart failure. The aim of this study was to analyze the influence of chronic renal failure, inflammation and heart disease in these biomarkers.

Patients and methods: In 266 patients with different stages of chronic renal diseases, the following parameters were measured: cardiac markers (TnT, BNP and NT-proBNP), renal function, inflammatory markers (hsCRP, fibrinogen, albumin, uric acid and white blood cells). We recorded the cardiovascular history. Ventricular dysfunction and left ventricular hypertrophy were assessed by echocardiography.

Results: A significant correlation between cardiac markers and inflammatory parameters such as fibrinogen, hsCRP and albumin was found. Age (OR 1.05, P = .021), serum albumin (OR: 0.06, P=.006), ischemic heart disease (OR: 8.17, P=.0092) and renal failure (OR: 1.67, P=.05) were predictors of higher BNP levels. Age (OR 1.05, P=.0097), serum albumin (OR: 0.12, P=.001), ischemic heart disease (OR: 3.43, P=.034), renal failure (OR: 1, 65, P=.036) and heart failure (OR: 4.33, P=.0312) were predictors of elevated NT-proBNP. Previous ischemic heart disease alone increased TnT levels (OR: 6.51, P=.0012).

Conclusions: Age, previous cardiac disease and inflammation increase cardiac marker levels in patients with different stages of renal disease, but the degree of renal failure is an important factor influencing NT-proBNP levels. However, ischemic heart disease alone increases the levels of TnT.

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Biomarkers / blood
  • Cross-Sectional Studies
  • Female
  • Heart Diseases / blood*
  • Heart Diseases / complications
  • Heart Diseases / diagnostic imaging
  • Humans
  • Inflammation / blood*
  • Inflammation / complications
  • Logistic Models
  • Male
  • Middle Aged
  • Natriuretic Peptide, Brain / blood*
  • Peptide Fragments / blood*
  • Renal Insufficiency, Chronic / blood*
  • Renal Insufficiency, Chronic / complications
  • Severity of Illness Index
  • Troponin T / blood*
  • Ultrasonography

Substances

  • Biomarkers
  • Peptide Fragments
  • Troponin T
  • pro-brain natriuretic peptide (1-76)
  • Natriuretic Peptide, Brain