Background Beta Trace Protein (BTP) is a biomarker for residual kidney function which has been linked to cardiovascular and all‐cause mortality in haemodialysis patients. Following renal transplantation, recipients remain at increased risk for cardiovascular events compared with the general population. We aimed to determine the relationship of pre‐transplant BTP to major adverse cardiac events (MACE) in patients following kidney transplantation. Methods We included 384 patients with end‐stage renal disease who received a kidney transplant. MACE was defined as myocardial infarction (ST‐segment elevation or non‐ST‐segment elevation, stroke or transient ischemic attack), coronary artery disease requiring intervention or bypass or death for cardiovascular reason. The association between pre‐transplant serum BTP concentration and post‐transplant MACE was evaluated by Kaplan–Meier and Cox regression analyses. Results Post‐transplant MACE occurred in 70/384 patients. Pre‐transplant BTP was significantly higher in patients with post‐transplant MACE (14.36 ± 5.73 mg/l vs. 11.26 ± 5.11 mg/l; p < .01). Next to smoking (HR 1.81), age > 56.38 years (HR 1.97) and pre‐existing coronary heart disease (HR 8.23), BTP above the cut off value of 12.7 mg/l was confirmed as independent risk factor for MACE (HR 2.02, all p < .05). MACE‐free survival inversely correlated with pre‐transplant BTP levels. Conclusions Pre‐transplant serum BTP concentration may identify renal transplant recipients with higher risk of post‐transplant MACE.

Background For the improvement of outcome after renal transplantation it is important to predict future risk of major adverse cardiac events as well as all-cause mortality. We aimed to determine the relationship of pre-transplant NT-proBNP with major adverse cardiac events and all-cause mortality after transplant in patients on the waiting-list with preserved left ventricular ejection fraction. Patients and methods We included 176 patients with end-stage renal disease and preserved left ventricular ejection fraction who received a kidney transplant. MACE was defined as myocardial infarction (ST-segment elevation [STEMI] or non-ST-segment elevation [NSTEMI]), stroke or transient ischemic attack), coronary artery disease requiring intervention or bypass or death from cardiovascular causes. Results MACE occurred in 28/176 patients. Patients with NT-proBNP levels above 4350 pg/ml had 1- and 5-year survival rates of 90.67% and 68.20%, whereas patients with NT-proBNP levels below 4350 pg/ml had 1- and 5-year survival rates of 100% and 90.48% (p < 0.01). 1- and 5-year MACE-free survival rates were calculated as 78.82% and 74.68% for patients with NT-proBNP > 4350 pg/ml and 93.33% and 91.21% for patients with NT-proBNP < 4350 pg/ml (p < 0.01). Conclusions Pre-transplant NT-proBNP might identify renal transplant candidates at risk for MACE after transplant.