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首页> 外文期刊>The American Journal of Cardiology >Multiple Biomarkers Including Cardiac Troponins T and I Measured by High-Sensitivity Assays, as Predictors of Long-Term Mortality in Patients With Chronic Renal Failure Who Underwent Dialysis
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Multiple Biomarkers Including Cardiac Troponins T and I Measured by High-Sensitivity Assays, as Predictors of Long-Term Mortality in Patients With Chronic Renal Failure Who Underwent Dialysis

机译：多种生物标志物，包括通过高敏感性分析测定的心肌肌钙蛋白T和I，可作为接受透析的慢性肾衰竭患者长期死亡率的预测指标

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There is a high cardiac mortality in patients on long-term renal dialysis. No studies have reported long-term outcomes relating to both high-sensitivity cardiac troponin T (hs-cTnT) and high-sensitivity cardiac troponin I (hs-cTnI) in these patients. Patients who underwent long-term dialysis at the Canberra Hospital had blood samples collected for both cardiac and other biomarkers. Samples were stored at -80 degrees C until analysis. Mortality data were collected at 5 years, and univariate and multivariate analyses were performed to identify which biomarkers were predictive of mortality at 5 years. After multivariate analysis, albumin, C-reactive protein (CRP), and hs-cTnT remained independently predictive of all-cause mortality, with hs-cTnT having the highest hazard ratio. If hs-cTnT was excluded from the analysis, then hs-cTnI was independently predictive of mortality. For hs-cTnT, for both genders, the ninety-ninth percentile, derived from a population with subjects with subclinical disease excluded, served as an excellent partition between survivors and non-survivors. Receiver-operating characteristic curve analysis for hs-cTnT had area under the curve of 0.798 and for hs-cTnI of 0.774. Kaplan-Meier curves for the aggregation of albumin, CRP, and hs-cTnT showed a stronger predictive power with receiver-operating characteristic area under the curve of 0.805. The addition of echocardiographic data in an analysis of all patients who had an echocardiogram for clinical reasons (n = 105) did not alter the final observations in this subgroup. In conclusion, hs-cTnT retains a superior predictive power in a dialysis-dependent population for identifying those at risk for death and when aggregated with albumin and CRP also has substantial additive value for identifying mortality risk in a renal-dialysis population. (C) 2015 Elsevier Inc. All rights reserved.
机译：长期肾透析患者的心脏死亡率很高。在这些患者中，尚无研究报道与高敏感性心脏肌钙蛋白T（hs-cTnT）和高敏感性心脏肌钙蛋白I（hs-cTnI）相关的长期结果。在堪培拉医院接受了长期透析的患者，其血液样本均采集了心脏和其他生物标记物。样品在-80摄氏度下保存直至分析。在5年时收集死亡率数据，并进行单因素和多因素分析，以确定哪些生物标志物可预测5年时的死亡率。经过多变量分析后，白蛋白，C反应蛋白（CRP）和hs-cTnT仍能独立预测全因死亡率，其中hs-cTnT的危险比最高。如果将hs-cTnT从分析中排除，则hs-cTnI可独立预测死亡率。对于hs-cTnT，无论男女，都来自被排除亚临床疾病受试者的人群中的百分之九十九，是幸存者与非幸存者之间的极佳划分。 hs-cTnT的接收者操作特征曲线分析的曲线下面积为0.798，hs-cTnI的接收者操作特征曲线分析为0.774。 Kaplan-Meier曲线对白蛋白，CRP和hs-cTnT的聚集表现出较强的预测能力，在0.805曲线以下具有接收者操作特征区域。在所有因临床原因进行超声心动图检查的患者（n = 105）的分析中，添加超声心动图数据均未改变该亚组的最终观察结果。总之，hs-cTnT在依赖透析的人群中具有较高的预测力，可用于识别有死亡风险的人群，当与白蛋白和CRP结合使用时，也具有重要的附加价值，可用于识别肾透析人群的死亡风险。 （C）2015 Elsevier Inc.保留所有权利。

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