GFR-specific cut-offs can refine the prognostic value of circulating cardiac biomarkers in advanced chronic kidney disease

Publication date: Available online 21 June 2019Source: Canadian Journal of CardiologyAuthor(s): Mark Canney, Mila Tang, Lee Er, Sean J. Barbour, Ognjenka Djurdjev, Adeera Levin, CanPREDDICT InvestigatorsAbstractBackgroundUsing standard cut-offs derived from healthy adults, high-sensitivity cardiac troponin T (hs-cTnT) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) are frequently elevated in patients with reduced glomerular filtration rate (GFR), with unclear implications. We sought to compare GFR-specific cut-offs of each biomarker to standard cut-offs for discrimination of cardiovascular risk in asymptomatic patients with chronic kidney disease (CKD).MethodsProspective cohort of 1956 participants with median GFR 27mL/min/1.73m2. Cox proportional hazards models were used to examine the association between each biomarker and first adjudicated cardiovascular event (unstable angina, myocardial infarction, heart failure, stroke, cardiovascular death). We used an outcome-based approach to identify optimal risk-based cut-offs for each biomarker within GFR strata (
Source: Canadian Journal of Cardiology - Category: Cardiology Source Type: research

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By WILLIAM H. BESTERMANN JR., MD New Scientific Breakthroughs Can Provide a Longer Healthier Life Twenty-one years of follow-up comparing usual care with a protocol-driven team-based intervention in diabetes proved that healthy life in humans can be prolonged by 8 years. These results were achieved at a lower per patient per year cost. Aging researchers have been confident that we will soon be able to prolong healthy life. This landmark study shows this ambitious goal can be achieved now with lifestyle intervention and a few highly effective proven medications. These medications interfere with the core molecular biol...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Medical Practice Patients aging chronic disease Denmark Diabetes William Bestermann Source Type: blogs
CONCLUSIONS: Canagliflozin significantly reduced major cardiovascular events, as well as kidney failure, in patients with type 2 diabetes and chronic kidney disease, including in participants who did not have prior cardiovascular disease. CLINICAL TRIAL REGISTRATION: URL: Unique identifier: NCT02065791. PMID: 31291786 [PubMed - as supplied by publisher]
Source: Circulation - Category: Cardiology Authors: Tags: Circulation Source Type: research
Conclusion: GFR-specific risk-based cutoffs for PTH1 –84 and FGF-23 may facilitate more meaningful risk stratification in advanced CKD than current GFR-agnostic reference ranges derived from healthy adults. This may be most applicable in those with severely reduced GFR.Am J Nephrol
Source: American Journal of Nephrology - Category: Neurology Source Type: research
Abstract BACKGROUND: In the majority of patients with advanced chronic kidney disease (CKD), values of parathyroid hormone (PTH1-84) and fibroblast growth factor 23 (FGF-23) exceed the normal reference range, potentially as an appropriate adaptation to reduced glomerular filtration rate (GFR). We tested whether GFR-specific cutoffs for PTH1-84 and FGF-23 could better identify patients with inappropriately high PTH1-84 and FGF-23 for their degree of CKD and thereby improve prognostication of clinical outcomes compared to a uniform threshold. METHODS: Prospective pan-Canadian cohort of 1,812 patients with mean ...
Source: American Journal of Nephrology - Category: Urology & Nephrology Authors: Tags: Am J Nephrol Source Type: research
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Source: Polish Heart Journal - Category: Cardiology Authors: Tags: Kardiol Pol Source Type: research
Authors: Mancusi C, Losi MA, Izzo R, Gerdts E, Canciello G, Arnone MI, Trimarco B, de Simone G, De Luca N Abstract OBJECTIVES: Increased arterial stiffness is associated with advanced arteriosclerosis, abnormal left ventricular (LV) geometry and function. Whether increased arterial stiffness is associated with incident cardiovascular (CV) event (MACE), independent of other markers of target organ damage needs to be clarified. METHODS: We selected hypertensive participants of the Campania Salute Network free of prevalent CV disease, with available echocardiogram and carotid ultrasound, ejection fraction ≥50%,...
Source: Blood Pressure - Category: Hematology Tags: Blood Press Source Type: research
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Source: Advances in Chronic Kidney Disease - Category: Urology & Nephrology Source Type: research
Fight Aging! provides a weekly digest of news and commentary for thousands of subscribers interested in the latest longevity science: progress towards the medical control of aging in order to prevent age-related frailty, suffering, and disease, as well as improvements in the present understanding of what works and what doesn't work when it comes to extending healthy life. Expect to see summaries of recent advances in medical research, news from the scientific community, advocacy and fundraising initiatives to help speed work on the repair and reversal of aging, links to online resources, and much more. This content is...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
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Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
Canagliflozin protects Heart and Kidneys – CREDENCE Trial Canagliflozin is sodium–glucose cotransporter 2 (SGLT2) inhibitor used in the treatment of type 2 diabetes mellitus. CREDENCE Trial [1] has shown that Canagliflozin provides both cardiovascular and renal protection in patients with type 2 diabetes mellitus. CREDENCE (Canagliflozin and Renal Events in Diabetes with Established Nephropathy Clinical Evaluation) trial was a double blind randomized trial comparing Canagliflozin 100 mg daily with placebo in type 2 diabetes with albuminuria and chronic kidney disease. They were also treated with renin–ang...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: Cardiology Source Type: blogs
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