Page 30 - Physical activity in recipients of solid organ transplantation - Edwin J. van Adrichem

Chapter 2
kidney function (Model 4). Additional adjustment for MR-proANP, NT-proBNP, and Hs-
TnT levels did not materially change the association between PA and CV-mortality nor
the association between PA and all-cause mortality (Table 3). PA was signi
cant after adjustment for confounders (Table 3). Potential interaction e

cantly
associated with non-cardiovascular mortality in the crude model, however, it was no longer
signi

ects between
the three cardiac markers and the level of PA were tested but were not signi

cant in
univariable or multivariable analyses.

PA and CV mortality indicates a hazard ratio of 0.87 (95% CI 0.80; 0.96,
e fully adjusted model of the association between
p
=0.004) per
log(base-2)-MET-min/day.
Table 2.
Hazard ratios for cardiovascular and all-cause mortality by cardiac marker
Cardiovascular mortality
All-cause mortality
Model
HR [95% CI] 1 1.62 [1.42; 1.83]
HR [95% CI] <0.001 1.53 [1.38; 1.70]
<0.001 1.31 [1.13; 1.51] 0.001 1.29 [1.12; 1.49]
<0.001 1.45 [1.33; 1.58] <0.001 1.25 [1.12; 1.40] 0.002 1.20 [1.08; 1.35]
<0.001 1.34 [1.22; 1.47] 0.002 1.29 [1.13; 1.47]
p
-value
p
-value
MR-proANP
2 1.41 [1.18; 1.69]
<0.001 <0.001 0.001
<0.001 <0.001 0.001
<0.001 <0.001
3 1.38 [1.15; 1.65] NT-proBNP
1 1.51 [1.36; 1.68]
2 1.32 [1.15; 1.51]
3 1.24 [1.08; 1.42]
Hs-TnT
1 1.36 [1.21; 1.53]
2 1.31 [1.11; 1.56]
Mediation by cardiac markers
3
1.29 [1.08; 1.55]
0.006
1.28 [1.11; 1.46]
<0.001
Model 1: Crude model of cardiac markers as z-scores. Model 2: Model 1 + adjusted for age, gender, and
eGFR. Model 3: Model 2 + adjusted for physical activity level (log2- MET-min/day). HR, Hazard
Ratio; CI, Con

dence Interval. MR-proANP, mid-regional pro-atrial natriuretic peptide; NT-proBNP,
N-terminal-pro brain natriuretic peptide; Hs-TnT, high sensitive troponine T; eGFR, estimated
glomerular

ltration rate.
Mediation analyses indicated that all cardiac markers were signi
association between PA and CV-mortality (Table 4).

e mediating e

cant mediators of the

ect of all cardiac
markers remained signi

cant after adjustment for gender, age, and eGFR. MR-proANP,
NT-proBNP, Hs-TnT were indicated to explain 20.9%, 32.7%, and 21.7% of the
association of PA with CV-mortality, respectively.

e RTR with higher levels of PA had
lower levels of cardiac markers and lower levels of mortality.
28.