Does Ultrasensitive Troponin have prognostic value in patients with chronic kidney disease on hemodialysis?
| Autor: | Julio Bono, Pablo Novoa, Oscar Kiener, R. Gugliermone, E. Moreyra, R. De Elias, Juan S Moreno |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
medicine.medical_specialty
Troponin T biology business.industry medicine.medical_treatment medicine.disease Gastroenterology Troponin End stage renal disease Surgery Diabetes mellitus Internal medicine medicine biology.protein Hemodialysis Cardiology and Cardiovascular Medicine business Dialysis Mace Kidney disease |
| Zdroj: | European Heart Journal. 34:P3081-P3081 |
| ISSN: | 1522-9645 0195-668X |
| DOI: | 10.1093/eurheartj/eht309.p3081 |
| Popis: | Introduction: Patients with end stage renal disease (Chronic Kidney Disease Stage 5-CKD 5) and no evidence of active ischemia often have elevated troponin T concentrations and increased cardiovascular events. It is unclear whether the high-sensitive troponin T (hsTn T) by its lower specificity has a prognostic role in CKD 5 patients. Objectives: Determine the prevalence and prognosis of elevated hsTn T concentration in hemodialysis patients without apparent clinical evidence of active ischemia. Evaluate independent predictors of elevated hsTn T in this group of patients. Methods: We measured hsTn T serum concentrations in CKD 5 dialysis patients at our institution, which were clinically stable and had no evidence of active ischemia. They were divided according to hsTn T levels into tertiles. All patients were followed for 6 months and the primary endpoint was mayor adverse cardiovascular events (MACE). Results: A total of 91 patients were included of which 95% had elevated levels of hsTn T (>14ng/l). The serum concentration of hsTn T in each group was: group 1: hsTn T = 6-37ng/l, group 2: HsTn T = 38-74ng/l, group 3: HsTn T = > 74ng/l. At 6 months the incidence of MACE increased progressively in each tertile (group 1= 1 patient (3%), group 2= 4 patients (8%), group 3= 8 patients (26%), p 74ng/l that remained were diabetes OR= 13.2 (95% CI 3.9 to 44.5) and fibrosis OR= 6.4 (95% CI 1.52 to 26.9). Patients with concentrations hsTnT >74 ng/l have 7.5 times more risk of MACE; for each year of age increased 10% the risk of MACE. Conclusions: Most patients in CDK 5 dialysis without apparent active ischemia have elevated HsTn T concentration. At higher hsTn T concentration there is a progressive risk of MACE. Independent predictors of elevated HsTn T levels are diabetes and fibrosis. |
| Databáze: | OpenAIRE |
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