Page 31 - Physical activity in recipients of solid organ transplantation - Edwin J. van Adrichem

Physical activity in recipients of solid organ transplantation
Table 3.
Hazard ratios and adjusted hazard ratios for cardiovascular and all-cause
mortality by physical activity as a log2-transformed continuous variable
Cardiovascular mortality Non cardiovascular mortality All-cause mortality
.
Model
1 0.82 [0.76; 0.88]
2 0.86 [0.79; 0.93]
3 0.86 [0.79; 0.94]
4 0.87 [0.80; 0.95]
p-value HR [95% CI] <0.001 0.87 [0.80; 0.95] <0.001 0.94 [0.85; 1.03] <0.001 0.94 [0.86; 1.04]
0.001 0.96 [0.87; 1.06]
p-value HR [95% CI] 0.001 0.85 [0.80; 0.89] 0.182 0.89 [0.84; 0.95] 0.214 0.89 [0.84; 0.95] 0.390 0.91 [0.85; 0.97]
p-value
<0.001 <0.001 <0.001
0.002
HR [95% CI]
5
0.87 [0.79; 0.95]
0.003
0.97 [0.87; 1.08]
0.578
0.92 [0.86; 0.98]
0.011
Model 1: Crude model of Physical Activity as a continuous variable (log2- MET-min/day), univariate.
Model 2: Model 1 + adjustment for age and gender. Model 3: Model 2 + adjustment for history of
cardiovascular events. Model 4: Model 3 + adjustments for eGFR and urinary protein excretion. Model
5: Model 4 + adjustments for MR-pro-ANP, NT-pro BNP, and Hs-TnT. 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.
Discussion

is post-hoc study substantiates that there is a signi
e levels of each of these markers are signi

cant association between the cardiac
biomarkers MR-proANP, NT-proBNP, and Hs-TnT, as well as CV- and all-cause
mortality in RTR.

cantly lower in RTR with
higher levels of PA. Interestingly, the link between PA and both CV- as well as all-cause
mortality is independent of all studied cardiac markers.

e cardiac markers, however, do
signi

cantly mediate the association between PA and CV-mortality with proportions
mediated ranging from 21% to 33%.

e associations between MR-proANP, NT-proBNP, Hs-TnT and mortality in our
cohort are comparable with

ndings in the general population
19–21
and are in accordance
with previous

ndings in RTR cohorts.
2,22

e association between the cardiac markers
and mortality tend to be even more pronounced in RTR, comparable levels lead to higher
mortality in RTR when compared to the general population.2
clearance of the markers from circulation by the kidney and with a detectable level in
30–32
However, as each of the markers remained signi
use of MR-proANP, NT-proBNP, and Hs-TnT as markers for risk strati

as a prognostic marker in a population with renal failure is debated because of the (partial)
almost all patients and ‘elevated’ levels in the majority of patients with chronic kidney
disease.

cantly associated with
mortality after adjustment for age, gender, and eGFR within the population of RTR, the

cation within the
RTR population is substantiated.
e value of cardiac markers
29.
2