Value of N-terminal brain natriuretic peptide as a prognostic marker in patients with CKD: results from the CREATE study
Locatelli, Francesco ; Eckardt, Kai-Uwe ; Macdougall, Iain C. ; Tsakiris, Dimitrios ; Clyne, Naomi LU
; Burger, Hans-Ulrich
; Scherhag, Armin
and Drueeke, Tilman B.
(2010)
In Current Medical Research and Opinion
26(11).
p.2543-2552
- Abstract
- Background and objectives: This study assessed plasma N-terminal prohormone brain natriuretic peptide (NT-proBNP) as a prognostic marker of cardiovascular risk in patients with chronic kidney disease stages 3-4 and anaemia treated with epoetin beta to two haemoglobin target ranges. Design, setting, participants & measurements: Of 603 patients enrolled in the C ardiovascular Risk Reduction by Early Anaemia Treatment with Epoetin Beta (CREATE) trial (baseline creatinine clearance 15-35 mL/min; haemoglobin 11.0-12.5 g/dL), 291 were included in this sub-study. Patients received subcutaneous epoetin beta either immediately after randomisation (target 13.0-15.0 g/dL; Group 1), or after their haemoglobin levels had fallen < 10.5 g/dL... (More)
- Background and objectives: This study assessed plasma N-terminal prohormone brain natriuretic peptide (NT-proBNP) as a prognostic marker of cardiovascular risk in patients with chronic kidney disease stages 3-4 and anaemia treated with epoetin beta to two haemoglobin target ranges. Design, setting, participants & measurements: Of 603 patients enrolled in the C ardiovascular Risk Reduction by Early Anaemia Treatment with Epoetin Beta (CREATE) trial (baseline creatinine clearance 15-35 mL/min; haemoglobin 11.0-12.5 g/dL), 291 were included in this sub-study. Patients received subcutaneous epoetin beta either immediately after randomisation (target 13.0-15.0 g/dL; Group 1), or after their haemoglobin levels had fallen < 10.5 g/dL (target 10.5-11.5 g/dL; Group 2). Chronic heart failure New York Heart Association class III-IV was an exclusion criterion. (ClinicalTrials.gov Identifier: NCT00321919) Results: Cardiovascular event rates were higher in patients with baseline NT-proBNP > 400 vs. 400 pg/mL (39 vs. 13 events; p = 0.0002). Dialysis was initiated in 68 vs. 42 patients with NT-proBNP > 400 vs. 400 pg/mL (p = 0.0003). Amongst patients with NT-proBNP > 400 pg/mL, there was no significant difference between treatment groups in risk of cardiovascular events (HR = 0.57; p = 0.08) or time to dialysis (HR = 0.65; p = 0.08). The overall interpretation of this substudy is, however, limited by its relatively small sample size which, together with low clinical event rates, result in a lack of statistical power for some analyses and should be viewed as being hypothesis-generating in nature. Conclusions: In chronic kidney disease patients with mild-to-moderate anaemia, elevated baseline plasma NT-proBNP levels are associated with a higher risk of cardiovascular events and an accelerated progression towards end-stage renal disease. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/1720979
- author
- Locatelli, Francesco
; Eckardt, Kai-Uwe
; Macdougall, Iain C.
; Tsakiris, Dimitrios
; Clyne, Naomi
LU
; Burger, Hans-Ulrich
; Scherhag, Armin
and Drueeke, Tilman B.
- organization
- publishing date
- 2010
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Current Medical Research and Opinion
- volume
- 26
- issue
- 11
- pages
- 2543 - 2552
- publisher
- LibraPharm
- external identifiers
-
- wos:000283153900004
- scopus:77958123335
- ISSN
- 1473-4877
- DOI
- 10.1185/03007995.2010.516237
- language
- English
- LU publication?
- yes
- id
- afafac1d-b9fe-416c-bcd5-cd42a40de65a (old id 1720979)
- date added to LUP
- 2016-04-01 10:09:12
- date last changed
- 2022-01-25 20:14:15
@article{afafac1d-b9fe-416c-bcd5-cd42a40de65a,
abstract = {{Background and objectives: This study assessed plasma N-terminal prohormone brain natriuretic peptide (NT-proBNP) as a prognostic marker of cardiovascular risk in patients with chronic kidney disease stages 3-4 and anaemia treated with epoetin beta to two haemoglobin target ranges. Design, setting, participants & measurements: Of 603 patients enrolled in the C ardiovascular Risk Reduction by Early Anaemia Treatment with Epoetin Beta (CREATE) trial (baseline creatinine clearance 15-35 mL/min; haemoglobin 11.0-12.5 g/dL), 291 were included in this sub-study. Patients received subcutaneous epoetin beta either immediately after randomisation (target 13.0-15.0 g/dL; Group 1), or after their haemoglobin levels had fallen < 10.5 g/dL (target 10.5-11.5 g/dL; Group 2). Chronic heart failure New York Heart Association class III-IV was an exclusion criterion. (ClinicalTrials.gov Identifier: NCT00321919) Results: Cardiovascular event rates were higher in patients with baseline NT-proBNP > 400 vs. 400 pg/mL (39 vs. 13 events; p = 0.0002). Dialysis was initiated in 68 vs. 42 patients with NT-proBNP > 400 vs. 400 pg/mL (p = 0.0003). Amongst patients with NT-proBNP > 400 pg/mL, there was no significant difference between treatment groups in risk of cardiovascular events (HR = 0.57; p = 0.08) or time to dialysis (HR = 0.65; p = 0.08). The overall interpretation of this substudy is, however, limited by its relatively small sample size which, together with low clinical event rates, result in a lack of statistical power for some analyses and should be viewed as being hypothesis-generating in nature. Conclusions: In chronic kidney disease patients with mild-to-moderate anaemia, elevated baseline plasma NT-proBNP levels are associated with a higher risk of cardiovascular events and an accelerated progression towards end-stage renal disease.}},
author = {{Locatelli, Francesco and Eckardt, Kai-Uwe and Macdougall, Iain C. and Tsakiris, Dimitrios and Clyne, Naomi and Burger, Hans-Ulrich and Scherhag, Armin and Drueeke, Tilman B.}},
issn = {{1473-4877}},
language = {{eng}},
number = {{11}},
pages = {{2543--2552}},
publisher = {{LibraPharm}},
series = {{Current Medical Research and Opinion}},
title = {{Value of N-terminal brain natriuretic peptide as a prognostic marker in patients with CKD: results from the CREATE study}},
url = {{http://dx.doi.org/10.1185/03007995.2010.516237}},
doi = {{10.1185/03007995.2010.516237}},
volume = {{26}},
year = {{2010}},
}