Association of Cardiac Biomarkers With the Kansas City Cardiomyopathy Questionnaire in Patients With Chronic Kidney Disease Without Heart Failure
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...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2020-07-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.119.014385 |
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| author | Sri Lekha Tummalapalli Leila R. Zelnick Amanda H. Andersen Robert H. Christenson Christopher R. deFilippi Rajat Deo Alan S. Go Jiang He Bonnie Ky James P. Lash Stephen L. Seliger Elsayed Z. Soliman Michael G. Shlipak Nisha Bansal |
| author_facet | Sri Lekha Tummalapalli Leila R. Zelnick Amanda H. Andersen Robert H. Christenson Christopher R. deFilippi Rajat Deo Alan S. Go Jiang He Bonnie Ky James P. Lash Stephen L. Seliger Elsayed Z. Soliman Michael G. Shlipak Nisha Bansal |
| author_sort | Sri Lekha Tummalapalli |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-23T04:52:54Z |
| format | Article |
| id | doaj.art-8822a7a1769242ceb5a38a0351d2b4e2 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-12-23T04:52:54Z |
| publishDate | 2020-07-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-8822a7a1769242ceb5a38a0351d2b4e22022-12-21T17:59:24ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802020-07-0191310.1161/JAHA.119.014385Association of Cardiac Biomarkers With the Kansas City Cardiomyopathy Questionnaire in Patients With Chronic Kidney Disease Without Heart FailureSri Lekha Tummalapalli0Leila R. Zelnick1Amanda H. Andersen2Robert H. Christenson3Christopher R. deFilippi4Rajat Deo5Alan S. Go6Jiang He7Bonnie Ky8James P. Lash9Stephen L. Seliger10Elsayed Z. Soliman11Michael G. Shlipak12Nisha Bansal13Division of Nephrology Department of Medicine University of California San Francisco CAKidney Research Institute University of Washington Seattle WABiostatistics and Epidemiology and Informatics Perelman School of Medicine at the University of Pennsylvania Philadelphia PADepartment of Pathology University of Maryland School of Medicine Baltimore MDUniversity of Maryland School of Medicine Baltimore MDDivision of Cardiovascular Medicine University of Pennsylvania Philadelphia PADepartment of Epidemiology and Biostatistics University of California, San Francisco San Francisco San Francisco CATulane University New Orleans LADivision of Cardiology Department of Medicine Perelman School of Medicine at the University of Pennsylvania Philadelphia PADepartment of Medicine University of Illinois at Chicago ILDivision of Nephrology University of Maryland School of Medicine Baltimore MDDepartment of Epidemiology and Prevention Epidemiological Cardiology Research Center Wake Forest University School of Medicine Winston‐Salem NCKidney Health Research Collaborative University of California San Francisco CAKidney Research Institute University of Washington Seattle WABackground 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.https://www.ahajournals.org/doi/10.1161/JAHA.119.014385cardiac biomarkersheart failurequality of life |
| spellingShingle | Sri Lekha Tummalapalli Leila R. Zelnick Amanda H. Andersen Robert H. Christenson Christopher R. deFilippi Rajat Deo Alan S. Go Jiang He Bonnie Ky James P. Lash Stephen L. Seliger Elsayed Z. Soliman Michael G. Shlipak Nisha Bansal Association of Cardiac Biomarkers With the Kansas City Cardiomyopathy Questionnaire in Patients With Chronic Kidney Disease Without Heart Failure Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease cardiac biomarkers heart failure quality of life |
| title | Association of Cardiac Biomarkers With the Kansas City Cardiomyopathy Questionnaire in Patients With Chronic Kidney Disease Without Heart Failure |
| title_full | Association of Cardiac Biomarkers With the Kansas City Cardiomyopathy Questionnaire in Patients With Chronic Kidney Disease Without Heart Failure |
| title_fullStr | Association of Cardiac Biomarkers With the Kansas City Cardiomyopathy Questionnaire in Patients With Chronic Kidney Disease Without Heart Failure |
| title_full_unstemmed | Association of Cardiac Biomarkers With the Kansas City Cardiomyopathy Questionnaire in Patients With Chronic Kidney Disease Without Heart Failure |
| title_short | Association of Cardiac Biomarkers With the Kansas City Cardiomyopathy Questionnaire in Patients With Chronic Kidney Disease Without Heart Failure |
| title_sort | association of cardiac biomarkers with the kansas city cardiomyopathy questionnaire in patients with chronic kidney disease without heart failure |
| topic | cardiac biomarkers heart failure quality of life |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.119.014385 |
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