| Value of N-terminal brain natriuretic peptide as a prognostic marker in patients with CKD: results from the CREATE study. | |
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MedLine Citation:
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PMID: 20849244 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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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 Cardiovascular 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. |
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Authors:
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Francesco Locatelli; Kai-Uwe Eckardt; Iain C Macdougall; Dimitrios Tsakiris; Naomi Clyne; Hans-Ulrich Burger; Armin Scherhag; Tilman B Drüeke; |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2010-09-17 |
Journal Detail:
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Title: Current medical research and opinion Volume: 26 ISSN: 1473-4877 ISO Abbreviation: Curr Med Res Opin Publication Date: 2010 Nov |
Date Detail:
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Created Date: 2010-10-20 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0351014 Medline TA: Curr Med Res Opin Country: England |
Other Details:
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Languages: eng Pagination: 2543-52 Citation Subset: IM |
Affiliation:
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Dialysis and Renal Transplantation, Ospedale A. Manzoni, Lecco, Italy. nephrologia@ospedale.lecco.it |
| Data Bank Information | |
Bank Name/Acc. No.:
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ClinicalTrials.gov/NCT00321919 |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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