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

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  • Additional Information
    • Corporate Authors:
      CRIC Study Investigators †
    • Source:
      Publisher: Wiley-Blackwell Country of Publication: England NLM ID: 101580524 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2047-9980 (Electronic) Linking ISSN: 20479980 NLM ISO Abbreviation: J Am Heart Assoc Subsets: MEDLINE
    • Publication Information:
      Original Publication: Oxford : Wiley-Blackwell
    • Subject Terms:
      Health Status Indicators* ; Surveys and Questionnaires*; Biomarkers/*blood ; Heart Failure/*diagnosis ; Renal Insufficiency, Chronic/*diagnosis; Adult ; Aged ; Blood Proteins ; Cross-Sectional Studies ; Female ; Galectins/blood ; Growth Differentiation Factor 15/blood ; Heart Failure/blood ; Heart Failure/epidemiology ; Humans ; Incidence ; Longitudinal Studies ; Male ; Middle Aged ; Natriuretic Peptide, Brain/blood ; Peptide Fragments/blood ; Predictive Value of Tests ; Prognosis ; Prospective Studies ; Renal Insufficiency, Chronic/blood ; Renal Insufficiency, Chronic/epidemiology ; Risk Assessment ; Risk Factors ; Time Factors ; Troponin T/blood ; United States/epidemiology
    • 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.
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    • Grant Information:
      UL1 TR000439 United States TR NCATS NIH HHS; UL1 TR000424 United States TR NCATS NIH HHS; UL1 TR002548 United States TR NCATS NIH HHS; P20 GM109036 United States GM NIGMS NIH HHS; U01 DK061021 United States DK NIDDK NIH HHS; U01 DK060980 United States DK NIDDK NIH HHS; U01 DK060963 United States DK NIDDK NIH HHS; U01 DK060984 United States DK NIDDK NIH HHS; M01 RR013987 United States RR NCRR NIH HHS; R01 DK103612 United States DK NIDDK NIH HHS; UL1 TR000003 United States TR NCATS NIH HHS; M01 RR016500 United States RR NCRR NIH HHS; U01 DK060990 United States DK NIDDK NIH HHS; UL1 RR024131 United States RR NCRR NIH HHS; U01 DK061028 United States DK NIDDK NIH HHS; U01 DK060902 United States DK NIDDK NIH HHS; K24 DK092290 United States DK NIDDK NIH HHS; R01 DK072231 United States DK NIDDK NIH HHS; U01 DK061022 United States DK NIDDK NIH HHS; UL1 TR000433 United States TR NCATS NIH HHS; UL1 RR029879 United States RR NCRR NIH HHS
    • Contributed Indexing:
      Investigator: LJ Appel; HI Feldman; AS Go; PS Rao; M Rahman; RR Townsend
      Keywords: cardiac biomarkers; heart failure; quality of life
    • Accession Number:
      0 (Biomarkers)
      0 (Blood Proteins)
      0 (GDF15 protein, human)
      0 (Galectins)
      0 (Growth Differentiation Factor 15)
      0 (LGALS3 protein, human)
      0 (Peptide Fragments)
      0 (Troponin T)
      0 (pro-brain natriuretic peptide (1-76))
      114471-18-0 (Natriuretic Peptide, Brain)
    • Publication Date:
      Date Created: 20200625 Date Completed: 20210309 Latest Revision: 20211203
    • Publication Date:
      20240628
    • Accession Number:
      PMC7670503
    • Accession Number:
      10.1161/JAHA.119.014385
    • Accession Number:
      32578483