Brief observationAssociation between troponin I levels and mortality in stable hemodialysis patients
Section snippets
Subjects
All patients undergoing chronic hemodialysis at the Mount Sinai Medical Center and the St. John’s Queens Hospital dialysis units were screened. Patients were excluded only if they had symptoms or a history of an acute coronary event (unstable angina, myocardial infarction, or revascularization) within the preceding 30 days or if they refused to participate in the study. The dialysis protocol at the participating institutions utilized Fresenius F6, F8, or F80 polysulfone membranes (Fresenius
Results
A total of 137 patients (mean [± SD] age, 58 ± 15 years) were enrolled in the study. The baseline characteristics of patients with normal troponin I levels were similar to those with elevated levels (>1.0 ng/mL), except that patients with elevated levels were slightly older and more likely to have a history of stable angina (Table).
At 15 months, 4 of the 10 patients in the elevated troponin I group died, compared with 12% (15/127) of those with normal levels (Figure). This difference remained
Discussion
Troponin I is a highly sensitive and specific marker for myocardial ischemia. Unlike creatine kinase, creatine kinase–MB, and even troponin T, it is not expressed by tissues other than the myocardium 9, 10, 11. This specificity has engendered a great deal of interest in its value as a marker of subclinical ischemia and as a predictor of adverse cardiac outcomes. In this study, we found that an elevated troponin I level was associated with 15-month mortality among hemodialysis patients.
We found
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Cited by (23)
Interpreting troponin in renal disease: A narrative review for emergency clinicians
2020, American Journal of Emergency MedicineCitation Excerpt :Elevation in cTn in patients with CKD is associated with poor short-term and long-term prognosis, whether the etiology of the cTn elevation is ACS or another condition [20,49,63–99]. Many studies suggest elevated cTn is associated with poor outcome, including higher mortality rates at 30 days and 1 year [63–99]. As the severity of renal disease increases with reduced eGFR, the risk of mortality also increases in patients with ACS [33,69,71].
Use and interpretation of high sensitivity cardiac troponins in patients with chronic kidney disease with and without acute myocardial infarction
2015, Clinical BiochemistryCitation Excerpt :It is worthy to note that none of the studies described above were conducted with the hs-cTn assays. Other studies evaluating possible renal elimination of cTn by looking at the effect of a dialysis treatment on levels of circulating cTn have had discrepant results [60–73]. Only a few such studies used the hs-cTn assays.
Cardiac troponin I and paraphenylene diamine poisoning
2007, Annales Francaises d'Anesthesie et de ReanimationCardiovascular Biomarkers in CKD: Pathophysiology and Implications for Clinical Management of Cardiac Disease
2006, American Journal of Kidney DiseasesTroponins in its context: From test tube to clinical arena
2004, Revista Clinica EspanolaResults of a study on high-sensitivity cardiac troponin i in a stable hemodialysis patient population
2019, Rivista Italiana della Medicina di Laboratorio