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High-sensitive cardiac troponin, NT-proBNP, hFABP and copeptin levels in relation to glomerular filtration rates and a medical record of cardiovascular disease

Artikel i vetenskaplig tidskrift
Författare Christian Bjurman
Max Petzold
P. Venge
Julia Farbemo
Michael Fu
Ola Hammarsten
Publicerad i Clinical Biochemistry
Volym 48
Nummer/häfte 4-5
Sidor 302-307
ISSN 0009-9120
Publiceringsår 2015
Publicerad vid Institutionen för biomedicin, avdelningen för klinisk kemi och transfusionsmedicin
Akademistatistik
Institutionen för medicin
Sidor 302-307
Språk en
Länkar dx.doi.org/10.1016/j.clinbiochem.20...
Ämnesord Cardiac biomarkers, Cardiac troponin, Kidney function, CHRONIC KIDNEY-DISEASE, BRAIN NATRIURETIC PEPTIDE, ACUTE, MYOCARDIAL-INFARCTION, ACUTE CORONARY SYNDROME, ACID-BINDING PROTEIN, CYSTATIN-C, HEART-FAILURE, RENAL-FUNCTION, SERUM CREATININE, CARDIORENAL, SYNDROME, Medical Laboratory Technology
Ämneskategorier Biokemi, Kemi

Sammanfattning

Background: Elevation of cardiac markers in patients with renal dysfunction has not been fully assessed reducing the diagnostic usefulness of these biomarkers. Objective: To examine the effects of renal function and a medical record of cardiovascular disease on levels of cardiac biomarkers. Methods: Serum samples were collected from 489 patients referred for GFR measurement using Cr51-EDTA or iohexol plasma clearance (measured GFR). The cardiac biomaiters Troponin T (hs-cTnT), Troponin I (hsTnI), N-Terminal pro Brain Natriuretic Peptide (NTproBNP), Copeptin, Human Fatty Acid Binding Protein (hFABP), as well as the kidney function biomarkers creatinine and cystatin C, were measured. Regression was used to analyse the relationship between biomarker levels and the glomerular filtration rate (GFR) between 15 and 90 mL/min/1.73 m(2). Results: Compared with normal kidney function, the estimated increases in the studied cardiac biomarkers at a CUR of 15 mL/mM/1.73 m(2) varied from 2-fold to 15 fold but were not very different between patients with or without a medical record of cardiovascular disease and were most prominent for cardiac biomarkers with low molecular weight. hs-cTnT levels correlated more strongly to measured CUR and increased more at low CUR compared to hs-cTnI. For hFABP and NT-proBNP increases at low kidney function were more correctly predicted by a local Cystatin C-based eGFR formula compared with creatinine-based eGFR (using the MDRD or CKD-EPI equations) Conclusion: The extent of the elevation of cardiac markers at low renal function is highly variable. For hFABP and NTproBNP Cystatin C-based eGFR provides better predictions of the extent of elevation compared to the MDRD or CKD-EPI equations. (C) 2015 The Authors. The Canadian Society of Clinical Chemists. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd,40/).

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