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Association of Cardiac Biomarkers With the Kansas City Cardiomyopathy Questionnaire in Patients With Chronic Kidney Disease Without Heart Failure.

TitleAssociation of Cardiac Biomarkers With the Kansas City Cardiomyopathy Questionnaire in Patients With Chronic Kidney Disease Without Heart Failure.
Publication TypeJournal Article
Year of Publication2020
AuthorsTummalapalli SLekha, Zelnick LR, Andersen AH, Christenson RH, deFilippi CR, Deo R, Go AS, He J, Ky B, Lash JP, Seliger SL, Soliman EZ, Shlipak MG, Bansal N
Corporate AuthorsCRIC Study Investigators †
JournalJ Am Heart Assoc
Volume9
Issue13
Paginatione014385
Date Published2020 Jul 07
ISSN2047-9980
Abstract

Background The Kansas City Cardiomyopathy Questionnaire (KCCQ) is a measure of heart failure (HF) health status. Worse KCCQ scores are common in patients with chronic kidney disease (CKD), even without diagnosed heart failure (HF). Elevations in the cardiac biomarkers GDF-15 (growth differentiation factor-15), galectin-3, sST2 (soluble suppression of tumorigenesis-2), hsTnT (high-sensitivity troponin T), and NT-proBNP (N-terminal pro-B-type natriuretic peptide) likely reflect subclinical HF in CKD. Whether cardiac biomarkers are associated with low KCCQ scores is not known. Methods and Results We studied participants with CKD without HF in the multicenter prospective CRIC (Chronic Renal Insufficiency Cohort) Study. Outcomes included (1) low KCCQ score <75 at year 1 and (2) incident decline in KCCQ score to <75. We used multivariable logistic regression and Cox regression models to evaluate the associations between baseline cardiac biomarkers and cross-sectional and longitudinal KCCQ scores. Among 2873 participants, GDF-15 (adjusted odds ratio 1.42 per SD; 99% CI, 1.19-1.68) and galectin-3 (1.28; 1.12-1.48) were significantly associated with KCCQ scores <75, whereas sST2, hsTnT, and NT-proBNP were not significantly associated with KCCQ scores <75 after multivariable adjustment. Of the 2132 participants with KCCQ ≥75 at year 1, GDF-15 (adjusted hazard ratio, 1.36 per SD; 99% CI, 1.12-1.65), hsTnT (1.20; 1.01-1.44), and NT-proBNP (1.30; 1.08-1.56) were associated with incident decline in KCCQ to <75 after multivariable adjustment, whereas galectin-3 and sST2 did not have significant associations with KCCQ decline. Conclusions Among participants with CKD without clinical HF GDF-15, galectin-3, NT-proBNP, and hsTnT were associated with low KCCQ either at baseline or during follow-up. Our findings show that elevations in cardiac biomarkers reflect early symptomatic changes in HF health status in CKD patients.

DOI10.1161/JAHA.119.014385
Alternate JournalJ Am Heart Assoc
PubMed ID32578483
Grant ListK24 DK092290 / DK / NIDDK NIH HHS / United States
M01 RR013987 / RR / NCRR NIH HHS / United States
R01 DK072231 / DK / NIDDK NIH HHS / United States
U01 DK060980 / DK / NIDDK NIH HHS / United States
Division: 
Healthcare Delivery Science & Innovation
Category: 
Faculty Publication