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dc.contributor.authorChen, Titi
dc.contributor.authorHassan, Hicham
dc.contributor.authorQian, Pierre
dc.contributor.authorVu, Monica
dc.contributor.authorMakris, Angela
dc.date.accessioned2019-06-27
dc.date.available2019-06-27
dc.date.issued2018-02-24
dc.identifier.urihttp://hdl.handle.net/2123/20643
dc.description.abstractBackground-—Dialysis patients have an exceedingly high mortality rate. Biomarkers may be useful tools in risk stratification of this population. We evaluated the prognostic value of high-sensitivity cardiac troponin T (hs-cTnT) and CRP (C-reactive protein) in predicting adverse outcomes in stable hemodialysis and peritoneal dialysis (PD) patients. Variability in hs-cTnT was also examined. Methods and Results-—A retrospective cohort study included 574 dialysis patients (hemodialysis 347, PD 227). Outcomes examined included mortality and major adverse cardiovascular events, with median follow-up of 3.5 years. hs-cTnT was an independent predictor of both outcomes in hemodialysis and PD patients. Increased risk only became significant when hs-cTnT reached quintile 3 (>49 ng/L). Area under the receiver operating curve analysis showed that the addition of hs-cTnT to clinical parameters significantly improved its prognostic performance for mortality in PD patients (P=0.002). CRP was an independent predictor of both outcomes in PD patients only. Only CRP in the highest quintile (>16.8 mg/L) was associated with increased risk. hs-cTnT remained relatively stable for the whole follow-up period for hemodialysis patients, whereas for PD patients, hs-cTnT increased by 23.63% in year 2 and 29.13% in year 3 compared with baseline (P<0.001). Conclusions-—hs-cTnT and CRP are useful tools in predicting mortality and major adverse cardiovascular events in hemodialysis and PD patients. Given that hs-cTnT levels increase over time in PD patients, interval monitoring may be valuable for risk assessment. In contrast, hs-cTnT in hemodialysis patients has little interval change and progress monitoring is not indicated. ( J Am Heart Assoc. 2018;7:e007876. DOI: 10.1161/JAHA.117.007876.)en_AU
dc.language.isoen_AUen_AU
dc.publisherJAHAen_AU
dc.relationNational Health and Medical Research Council (NHMRC) and National Heart Foundation of Australia (NHF) co-funded postgraduate scholarship (NHMRC Scholarship No. 1114408, NHF Scholarship No. 101107).en_AU
dc.titleHigh-Sensitivity Troponin T and C-Reactive Protein Have Different Prognostic Values in Hemo- and Peritoneal Dialysis Populations: A Cohort Studyen_AU
dc.typeArticleen_AU
dc.type.pubtypePublisher's versionen_AU


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