The Ratio of NT-proBNP to CysC1.53 Predicts Heart Failure in Patients With Chronic Kidney Disease

Background: The N-terminal pro B type natriuretic peptide (NT-proBNP) is important for prognosis of heart failure in patients with chronic kidney disease (CKD). However, the NT-proBNP level is easily affected by renal insufficiency, which limits its clinical use.Methods: This study included 396 pati...

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Main Authors: Sheng Wang, Ming Li, Xiangyu Wang, Jing Luo, Yulin Zou, Yang Hu, Xingtai Liu, Hua Ao, Xueer Yao, Chufeng Li, Tingting Yang
Format: Article
Language:English
Published: Frontiers Media S.A. 2021-11-01
Series:Frontiers in Cardiovascular Medicine
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fcvm.2021.731864/full
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author Sheng Wang
Ming Li
Xiangyu Wang
Jing Luo
Yulin Zou
Yang Hu
Xingtai Liu
Hua Ao
Xueer Yao
Chufeng Li
Tingting Yang
author_facet Sheng Wang
Ming Li
Xiangyu Wang
Jing Luo
Yulin Zou
Yang Hu
Xingtai Liu
Hua Ao
Xueer Yao
Chufeng Li
Tingting Yang
author_sort Sheng Wang
collection DOAJ
description Background: The N-terminal pro B type natriuretic peptide (NT-proBNP) is important for prognosis of heart failure in patients with chronic kidney disease (CKD). However, the NT-proBNP level is easily affected by renal insufficiency, which limits its clinical use.Methods: This study included 396 patients with CKD. Plasma levels of NT-proBNP and cystatin C (CysC) were measured during hospitalization. The echocardiographic parameters were also detected. Patients were divided into the heart failure group and control group according to the European Society of Cardiology Guideline on Chronic Heart Failure 2021. Multiple modeling analysis of the values of NT-proBNP and CysC, including NT-proBNP/Cyscn and NT-proBNP/nCysC was performed. The receiver operating characteristic (ROC) curve, combined with the cardiac function, was used to determine the formula with the best diagnostic efficiency. Then, the sensitivity and specificity of new predictors for cardiac insufficiency in CKD patients were calculated. Pearson correlation analysis was used to analyze the relationship between new predictors and the NT-proBNP level. The clinical data of CKD patients from another local hospital were used to validate the new predictors and the cut-off values.Results: An elevated NT-proBNP/CysC1.53 ratio was an independent risk factor for cardiac dysfunction in CKD and the best predictor derived from multiple modeling analysis. There was no correlation between the NT-proBNP/CysC1.53 ratio and the NT-proBNP level (r = 0.376, p = 6.909). The area under the ROC curve for the NT-proBNP/CysC1.53 ratio was 0.815 (95% confidence interval: 0.772–0.858), and for a cut-off point of 847.964, this ratio had a sensitivity of 78.24%, and a specificity of 69.44%. When applied to the data of CKD patients from another local hospital, the NT-proBNP to CysC1.53 ratio had a sensitivity of 70.27% and a specificity of 67.74%.Conclusion: The NT-proBNP to CysC1.53 ratio was superior to NT-proBNP alone for predicting cardiac dysfunction in patients with CKD.
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spelling doaj.art-19afea879a3a4b72b10dac050f83ec5a2022-12-21T19:53:54ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2021-11-01810.3389/fcvm.2021.731864731864The Ratio of NT-proBNP to CysC1.53 Predicts Heart Failure in Patients With Chronic Kidney DiseaseSheng Wang0Ming Li1Xiangyu Wang2Jing Luo3Yulin Zou4Yang Hu5Xingtai Liu6Hua Ao7Xueer Yao8Chufeng Li9Tingting Yang10Department of Clinical Laboratory, The Third Clinical Medical College of the Three Gorges University, Gezhouba Central Hospital of Sinopharm, Yichang, ChinaDepartment of Nephrology, The Third Clinical Medical College of the Three Gorges University, Gezhouba Central Hospital of Sinopharm, Yichang, ChinaDepartment of Neurology, The Third Clinical Medical College of the Three Gorges University, Gezhouba Central Hospital of Sinopharm, Yichang, ChinaDepartment of Medical Business, The Third Clinical Medical College of the Three Gorges University, Gezhouba Central Hospital of Sinopharm, Yichang, ChinaDepartment of Pharmacy, The Third Clinical Medical College of the Three Gorges University, Gezhouba Central Hospital of Sinopharm, Yichang, ChinaDepartment of Pain and Rehabilitation, The Third Clinical Medical College of the Three Gorges University, Gezhouba Central Hospital of Sinopharm, Yichang, ChinaDepartment of Clinical Laboratory, The Third Clinical Medical College of the Three Gorges University, Gezhouba Central Hospital of Sinopharm, Yichang, ChinaDepartment of Nephrology, The Third Clinical Medical College of the Three Gorges University, Gezhouba Central Hospital of Sinopharm, Yichang, ChinaDepartment of Ultrasound, The Third Clinical Medical College of the Three Gorges University, Gezhouba Central Hospital of Sinopharm, Yichang, ChinaDepartment of Clinical Laboratory, The Third Clinical Medical College of the Three Gorges University, Gezhouba Central Hospital of Sinopharm, Yichang, ChinaDepartment of Endocrinology, The Third Clinical Medical College of the Three Gorges University, Gezhouba Central Hospital of Sinopharm, Yichang, ChinaBackground: The N-terminal pro B type natriuretic peptide (NT-proBNP) is important for prognosis of heart failure in patients with chronic kidney disease (CKD). However, the NT-proBNP level is easily affected by renal insufficiency, which limits its clinical use.Methods: This study included 396 patients with CKD. Plasma levels of NT-proBNP and cystatin C (CysC) were measured during hospitalization. The echocardiographic parameters were also detected. Patients were divided into the heart failure group and control group according to the European Society of Cardiology Guideline on Chronic Heart Failure 2021. Multiple modeling analysis of the values of NT-proBNP and CysC, including NT-proBNP/Cyscn and NT-proBNP/nCysC was performed. The receiver operating characteristic (ROC) curve, combined with the cardiac function, was used to determine the formula with the best diagnostic efficiency. Then, the sensitivity and specificity of new predictors for cardiac insufficiency in CKD patients were calculated. Pearson correlation analysis was used to analyze the relationship between new predictors and the NT-proBNP level. The clinical data of CKD patients from another local hospital were used to validate the new predictors and the cut-off values.Results: An elevated NT-proBNP/CysC1.53 ratio was an independent risk factor for cardiac dysfunction in CKD and the best predictor derived from multiple modeling analysis. There was no correlation between the NT-proBNP/CysC1.53 ratio and the NT-proBNP level (r = 0.376, p = 6.909). The area under the ROC curve for the NT-proBNP/CysC1.53 ratio was 0.815 (95% confidence interval: 0.772–0.858), and for a cut-off point of 847.964, this ratio had a sensitivity of 78.24%, and a specificity of 69.44%. When applied to the data of CKD patients from another local hospital, the NT-proBNP to CysC1.53 ratio had a sensitivity of 70.27% and a specificity of 67.74%.Conclusion: The NT-proBNP to CysC1.53 ratio was superior to NT-proBNP alone for predicting cardiac dysfunction in patients with CKD.https://www.frontiersin.org/articles/10.3389/fcvm.2021.731864/fullchronic kidney diseaseheart failureNT-proBNPCysCcombined diagnostic index
spellingShingle Sheng Wang
Ming Li
Xiangyu Wang
Jing Luo
Yulin Zou
Yang Hu
Xingtai Liu
Hua Ao
Xueer Yao
Chufeng Li
Tingting Yang
The Ratio of NT-proBNP to CysC1.53 Predicts Heart Failure in Patients With Chronic Kidney Disease
Frontiers in Cardiovascular Medicine
chronic kidney disease
heart failure
NT-proBNP
CysC
combined diagnostic index
title The Ratio of NT-proBNP to CysC1.53 Predicts Heart Failure in Patients With Chronic Kidney Disease
title_full The Ratio of NT-proBNP to CysC1.53 Predicts Heart Failure in Patients With Chronic Kidney Disease
title_fullStr The Ratio of NT-proBNP to CysC1.53 Predicts Heart Failure in Patients With Chronic Kidney Disease
title_full_unstemmed The Ratio of NT-proBNP to CysC1.53 Predicts Heart Failure in Patients With Chronic Kidney Disease
title_short The Ratio of NT-proBNP to CysC1.53 Predicts Heart Failure in Patients With Chronic Kidney Disease
title_sort ratio of nt probnp to cysc1 53 predicts heart failure in patients with chronic kidney disease
topic chronic kidney disease
heart failure
NT-proBNP
CysC
combined diagnostic index
url https://www.frontiersin.org/articles/10.3389/fcvm.2021.731864/full
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