Brief observation
Association between troponin I levels and mortality in stable hemodialysis patients

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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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