{"id":{"repo_id":"qu-belfast","oai_identifier":"oai:pure.qub.ac.uk/portal:studenttheses/6adf09e9-fe31-4300-bee8-3ca15c16ae68"},"canonical_url":"https://search.dev.ndltd.org/etd/qu-belfast/oai:pure.qub.ac.uk/portal:studenttheses/6adf09e9-fe31-4300-bee8-3ca15c16ae68","repository":{"repo_id":"qu-belfast","name":"Queen's University Belfast","base_url":"https://pureadmin.qub.ac.uk/ws/oai"},"display":{"title":"Biomarkers of Cardiovascular Disease in Renal Transplant Recipients","abstract":"Background:<br/>Cardiovascular disease is a leading cause of premature mortality in renal transplant recipients. Predicting the risk of future cardiovascular events in this patient cohort is challenging due to the prevalence of non-traditional risk factors. Biomarkers of cardiovascular disease have been demonstrated to improve the accuracy of cardiovascular prediction models in the general population, but their potential utility in renal transplant recipients is unclear.<br/><br/>Aims and Objectives:<br/>This thesis aims to assess whether established biomarkers of cardiovascular disease are predictive of adverse outcomes in stable renal transplant recipients. <br/><br/>Patients and Methods:<br/>A cohort of 379 renal transplant recipients were studied. Prospective follow-up data (median of 16.2 years) were available for adverse outcomes including mortality, major adverse cardiovascular events (MACE) and graft loss. C-reactive protein (CRP), troponin T (TnT), N-terminal pro-B-type natriuretic peptide (NT-proBNP) and soluble ST2 (sST2) were measured from stored plasma/serum samples and investigated for an association with these outcomes. Discrimination metrics were derived to quantify the incremental value of adding biomarker concentrations to existing cardiovascular risk prediction models. <br/><br/>Results:<br/>Cardiovascular disease was the leading cause of mortality in the cohort and accounted for 47% of deaths. Malignancy (28%) and infection (22%) were also common causes of mortality. All of the biomarkers associated with all-cause and cardiovascular mortality, though the strength of association varied considerably. CRP, TnT and NT-proBNP were also associated with MACE. Overall, TnT and NT-proBNP moderately improved the accuracy of risk prediction models. Several biomarkers were associated with secondary outcomes including death-censored graft loss and infection-related mortality, highlighting a potential role for these biomarkers outside of cardiovascular risk prediction. <br/><br/>Conclusions:<br/>Data from these studies suggest that established biomarkers of cardiovascular disease may have a role in predicting adverse outcomes in renal transplant recipients, including several which are unrelated to cardiovascular disease.<br/>","abstract_html":"Background:&lt;br/&gt;Cardiovascular disease is a leading cause of premature mortality in renal transplant recipients. Predicting the risk of future cardiovascular events in this patient cohort is challenging due to the prevalence of non-traditional risk factors. Biomarkers of cardiovascular disease have been demonstrated to improve the accuracy of cardiovascular prediction models in the general population, but their potential utility in renal transplant recipients is unclear.&lt;br/&gt;&lt;br/&gt;Aims and Objectives:&lt;br/&gt;This thesis aims to assess whether established biomarkers of cardiovascular disease are predictive of adverse outcomes in stable renal transplant recipients. &lt;br/&gt;&lt;br/&gt;Patients and Methods:&lt;br/&gt;A cohort of 379 renal transplant recipients were studied. Prospective follow-up data (median of 16.2 years) were available for adverse outcomes including mortality, major adverse cardiovascular events (MACE) and graft loss. C-reactive protein (CRP), troponin T (TnT), N-terminal pro-B-type natriuretic peptide (NT-proBNP) and soluble ST2 (sST2) were measured from stored plasma/serum samples and investigated for an association with these outcomes. Discrimination metrics were derived to quantify the incremental value of adding biomarker concentrations to existing cardiovascular risk prediction models. &lt;br/&gt;&lt;br/&gt;Results:&lt;br/&gt;Cardiovascular disease was the leading cause of mortality in the cohort and accounted for 47% of deaths. Malignancy (28%) and infection (22%) were also common causes of mortality. All of the biomarkers associated with all-cause and cardiovascular mortality, though the strength of association varied considerably. CRP, TnT and NT-proBNP were also associated with MACE. Overall, TnT and NT-proBNP moderately improved the accuracy of risk prediction models. Several biomarkers were associated with secondary outcomes including death-censored graft loss and infection-related mortality, highlighting a potential role for these biomarkers outside of cardiovascular risk prediction. &lt;br/&gt;&lt;br/&gt;Conclusions:&lt;br/&gt;Data from these studies suggest that established biomarkers of cardiovascular disease may have a role in predicting adverse outcomes in renal transplant recipients, including several which are unrelated to cardiovascular disease.&lt;br/&gt;","abstract_has_math":false,"creators":["Devine, Paul"],"institution":"Queen's University Belfast","degree_name":"Doctor of Philosophy","degree_level":"Doctoral Thesis","degree_discipline":null,"degree_department":null,"school":null,"contributors":[],"advisors":["Maxwell, Alexander","Cardwell, Christopher"],"committee_chairs":[],"committee_members":[],"year":2019,"date_issued":"2019-12","date_published":"2019-12","updated_at":"2026-07-24T03:55:12Z","subjects":["kidney transplantation","cardiovascular disease","biomarkers","risk factors"],"languages":["eng"],"rights":[],"rights_urls":[],"identifier_entries":[{"key":"dc:identifier","label":"Identifier","values":["oai:pure.qub.ac.uk/portal:studenttheses/6adf09e9-fe31-4300-bee8-3ca15c16ae68"],"render_values":[{"text":"oai:pure.qub.ac.uk/portal:studenttheses/6adf09e9-fe31-4300-bee8-3ca15c16ae68","href":null,"code":true}]}]},"links":{"outbound_url":"https://pure.qub.ac.uk/en/studentTheses/6adf09e9-fe31-4300-bee8-3ca15c16ae68","outbound_label":"Repository record","outbound_source":"dc:identifier"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor.advisor","label":"Advisor","values":["Maxwell, Alexander","Cardwell, Christopher"]},{"key":"dc:contributor.sponsor","label":"Sponsor","values":["NI Kidney Research Fund"]},{"key":"dc:creator","label":"Author","values":["Devine, Paul"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date","label":"Dc Date","values":["2019-12"]},{"key":"dc:date.issued","label":"Date","values":["2019-12"]},{"key":"dc:publisher.department","label":"Dc Publisher Department","values":["School of Medicine, Dentistry and Biomedical Sciences"]},{"key":"dc:publisher.institution","label":"Dc Publisher Institution","values":["Queen's University Belfast"]},{"key":"dc:relation.isreferencedby","label":"Dc Relation Isreferencedby","values":["https://pure.qub.ac.uk/en/studentTheses/6adf09e9-fe31-4300-bee8-3ca15c16ae68"]},{"key":"dc:type","label":"Dc Type","values":["Thesis"]},{"key":"dc:type.qualificationlevel","label":"Dc Type Qualificationlevel","values":["Doctoral Thesis"]},{"key":"dc:type.qualificationname","label":"Dc Type Qualificationname","values":["Doctor of Philosophy"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["kidney transplantation","cardiovascular disease","biomarkers","risk factors"]}]},{"id":"language_rights","label":"Language and Rights","entries":[{"key":"dc:language","label":"Dc Language","values":["eng"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier","label":"Identifier","values":["oai:pure.qub.ac.uk/portal:studenttheses/6adf09e9-fe31-4300-bee8-3ca15c16ae68","https://pure.qub.ac.uk/en/studentTheses/6adf09e9-fe31-4300-bee8-3ca15c16ae68"]},{"key":"dc:identifier.uri","label":"Identifier URI","values":["https://pure.qub.ac.uk/files/212387060/Biomarkers_of_Cardiovascular_Disease.pdf"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description.abstract","label":"Abstract","values":["Background:<br/>Cardiovascular disease is a leading cause of premature mortality in renal transplant recipients. Predicting the risk of future cardiovascular events in this patient cohort is challenging due to the prevalence of non-traditional risk factors. Biomarkers of cardiovascular disease have been demonstrated to improve the accuracy of cardiovascular prediction models in the general population, but their potential utility in renal transplant recipients is unclear.<br/><br/>Aims and Objectives:<br/>This thesis aims to assess whether established biomarkers of cardiovascular disease are predictive of adverse outcomes in stable renal transplant recipients. <br/><br/>Patients and Methods:<br/>A cohort of 379 renal transplant recipients were studied. Prospective follow-up data (median of 16.2 years) were available for adverse outcomes including mortality, major adverse cardiovascular events (MACE) and graft loss. C-reactive protein (CRP), troponin T (TnT), N-terminal pro-B-type natriuretic peptide (NT-proBNP) and soluble ST2 (sST2) were measured from stored plasma/serum samples and investigated for an association with these outcomes. Discrimination metrics were derived to quantify the incremental value of adding biomarker concentrations to existing cardiovascular risk prediction models. <br/><br/>Results:<br/>Cardiovascular disease was the leading cause of mortality in the cohort and accounted for 47% of deaths. Malignancy (28%) and infection (22%) were also common causes of mortality. All of the biomarkers associated with all-cause and cardiovascular mortality, though the strength of association varied considerably. CRP, TnT and NT-proBNP were also associated with MACE. Overall, TnT and NT-proBNP moderately improved the accuracy of risk prediction models. Several biomarkers were associated with secondary outcomes including death-censored graft loss and infection-related mortality, highlighting a potential role for these biomarkers outside of cardiovascular risk prediction. <br/><br/>Conclusions:<br/>Data from these studies suggest that established biomarkers of cardiovascular disease may have a role in predicting adverse outcomes in renal transplant recipients, including several which are unrelated to cardiovascular disease.<br/>"]},{"key":"dc:title","label":"Title","values":["Biomarkers of Cardiovascular Disease in Renal Transplant Recipients"]}]}],"canonical_facts":{"dc:contributor.advisor":["Maxwell, Alexander","Cardwell, Christopher"],"dc:contributor.sponsor":["NI Kidney Research Fund"],"dc:creator":["Devine, Paul"],"dc:date":["2019-12"],"dc:date.issued":["2019-12"],"dc:description.abstract":["Background:<br/>Cardiovascular disease is a leading cause of premature mortality in renal transplant recipients. Predicting the risk of future cardiovascular events in this patient cohort is challenging due to the prevalence of non-traditional risk factors. Biomarkers of cardiovascular disease have been demonstrated to improve the accuracy of cardiovascular prediction models in the general population, but their potential utility in renal transplant recipients is unclear.<br/><br/>Aims and Objectives:<br/>This thesis aims to assess whether established biomarkers of cardiovascular disease are predictive of adverse outcomes in stable renal transplant recipients. <br/><br/>Patients and Methods:<br/>A cohort of 379 renal transplant recipients were studied. Prospective follow-up data (median of 16.2 years) were available for adverse outcomes including mortality, major adverse cardiovascular events (MACE) and graft loss. C-reactive protein (CRP), troponin T (TnT), N-terminal pro-B-type natriuretic peptide (NT-proBNP) and soluble ST2 (sST2) were measured from stored plasma/serum samples and investigated for an association with these outcomes. Discrimination metrics were derived to quantify the incremental value of adding biomarker concentrations to existing cardiovascular risk prediction models. <br/><br/>Results:<br/>Cardiovascular disease was the leading cause of mortality in the cohort and accounted for 47% of deaths. Malignancy (28%) and infection (22%) were also common causes of mortality. All of the biomarkers associated with all-cause and cardiovascular mortality, though the strength of association varied considerably. CRP, TnT and NT-proBNP were also associated with MACE. Overall, TnT and NT-proBNP moderately improved the accuracy of risk prediction models. Several biomarkers were associated with secondary outcomes including death-censored graft loss and infection-related mortality, highlighting a potential role for these biomarkers outside of cardiovascular risk prediction. <br/><br/>Conclusions:<br/>Data from these studies suggest that established biomarkers of cardiovascular disease may have a role in predicting adverse outcomes in renal transplant recipients, including several which are unrelated to cardiovascular disease.<br/>"],"dc:identifier":["oai:pure.qub.ac.uk/portal:studenttheses/6adf09e9-fe31-4300-bee8-3ca15c16ae68","https://pure.qub.ac.uk/en/studentTheses/6adf09e9-fe31-4300-bee8-3ca15c16ae68"],"dc:identifier.uri":["https://pure.qub.ac.uk/files/212387060/Biomarkers_of_Cardiovascular_Disease.pdf"],"dc:language":["eng"],"dc:publisher.department":["School of Medicine, Dentistry and Biomedical Sciences"],"dc:publisher.institution":["Queen's University Belfast"],"dc:relation.isreferencedby":["https://pure.qub.ac.uk/en/studentTheses/6adf09e9-fe31-4300-bee8-3ca15c16ae68"],"dc:subject":["kidney transplantation","cardiovascular disease","biomarkers","risk factors"],"dc:title":["Biomarkers of Cardiovascular Disease in Renal Transplant Recipients"],"dc:type":["Thesis"],"dc:type.qualificationlevel":["Doctoral Thesis"],"dc:type.qualificationname":["Doctor of Philosophy"]},"updated_at":"2026-07-24T03:55:12Z"}