{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T20:24:44Z","timestamp":1788553484347,"version":"build-2803163510"},"reference-count":65,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">The impact of chronic kidney disease (CKD) on the prognostic utility of cardiovascular biomarkers in high\u2010risk patients remains unclear.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">We performed a multicenter, prospective cohort study of 3255 patients with suspected or known coronary artery disease (CAD) to investigate whether CKD modifies the prognostic utility of cardiovascular biomarkers. Serum levels of cardiovascular and renal biomarkers, including soluble fms\u2010like tyrosine kinase\u20101 (sFlt\u20101), N\u2010terminal pro\u2010brain natriuretic peptide (NT\u2010proBNP), high\u2010sensitivity cardiac troponin\u2010I (hs\u2010cTnI), cystatin C, and placental growth factor, were measured in 1301 CKD and 1954 patients without CKD. The urine albumin to creatinine ratio (UACR) was measured in patients with CKD. The primary outcome was 3\u2010point MACE (3P\u2010MACE) defined as a composite of cardiovascular death, nonfatal myocardial infarction, and nonfatal stroke. The secondary outcomes were all\u2010cause death, cardiovascular death, and 5P\u2010MACE defined as a composite of 3P\u2010MACE, heart failure hospitalization, and coronary\/peripheral artery revascularization. After adjustment for clinical confounders, sFlt\u20101, NT\u2010proBNP, and hs\u2010cTnI, but not other biomarkers, were significantly associated with 3P\u2010MACE, all\u2010cause death, and cardiovascular death in the entire cohort and in patients without CKD. These associations were still significant in CKD only for NT\u2010proBNP and hs\u2010cTnI. NT\u2010proBNP and hs\u2010cTnI were also significantly associated with 5P\u2010MACE in CKD. The UACR was not significantly associated with any outcomes in CKD. NT\u2010proBNP and hs\u2010cTnI added incremental prognostic information for all outcomes to the model with potential clinical confounders in CKD.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">NT\u2010proBNP and hs\u2010cTnI were the most powerful prognostic biomarkers in patients with suspected or known CAD and concomitant CKD.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.121.023464","type":"journal-article","created":{"date-parts":[[2022,1,20]],"date-time":"2022-01-20T10:10:42Z","timestamp":1642673442000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":16,"title":["Impact of Chronic Kidney Disease on the Associations of Cardiovascular Biomarkers With Adverse Outcomes in Patients With Suspected or Known Coronary Artery Disease: The EXCEED\u2010J 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