کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
2861411 1572394 2006 5 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Usefulness of Clinical Evaluation, Troponins, and C-Reactive Protein in Predicting Mortality Among Stable Hemodialysis Patients
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی کاردیولوژی و پزشکی قلب و عروق
پیش نمایش صفحه اول مقاله
Usefulness of Clinical Evaluation, Troponins, and C-Reactive Protein in Predicting Mortality Among Stable Hemodialysis Patients
چکیده انگلیسی

This study prospectively examined the hypothesis that dividing stable dialysis patients into different clinical subsets by presence or absence of coronary disease equivalent will lead to clearer risk stratification by abnormal troponins and highly sensitive C-reactive protein (hs-CRP). Patients with end-stage renal disease have an annual mortality of 18%. Previous studies have shown that elevated cardiac troponins T and I and hs-CRP predict increased mortality, although these studies have not taken clinical parameters into account. Stable patients with end-stage renal disease (n = 173) were divided into 2 groups: 115 patients with coronary disease equivalent (known coronary or peripheral vascular disease or diabetes mellitus) and 58 patients without it. The 2 groups were then stratified by biomarkers (cardiac troponins T and I and hs-CRP) and followed for 27 months. The primary outcome was all-cause mortality. Patients with coronary disease equivalent had twofold greater annual mortality than those without (20.4% vs 9.8%, p = 0.003). Among patients with coronary disease equivalent, those with elevated troponins had a further increase in the risk for death relative to patients with normal troponins (25% vs 9% with cardiac troponin I elevation, p <0.001; 24% vs 12% with cardiac troponin T elevation, p = 0.04). hs-CRP did not add to the risk stratification of patients with coronary disease equivalent. Conversely, in patients without coronary disease equivalent, neither troponin further predicted the risk for death. In the small subset of patients without coronary disease equivalent who had hs-CRP ≥3 mg/L, mortality was significantly increased (p = 0.01). In conclusion, initial clinical assessment, followed by the addition of biomarkers, can be used to risk-stratify stable patients with end-stage renal disease.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: The American Journal of Cardiology - Volume 98, Issue 9, 1 November 2006, Pages 1283–1287
نویسندگان
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