Prognostic value of troponin T in hemodialysis patients is independent of comorbidity
| Autor: | I. S. Henderson, Patrick B. Deegan, Aubrey Blumsohn, Ellon McGregor, Maureen E. Lafferty |
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| Rok vydání: | 2001 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment acute myocardial infarction Comorbidity Asymptomatic end-stage renal failure Cohort Studies Troponin complex Troponin T cardiovascular disease Renal Dialysis Internal medicine Cause of Death Medicine Humans Myocardial infarction Dialysis Survival analysis Aged Aged 80 and over business.industry Myocardium Middle Aged medicine.disease Prognosis ischemic heart disease Survival Analysis Surgery Treatment Outcome ROC Curve Nephrology peripheral vascular disease Cardiology Regression Analysis Female Hemodialysis medicine.symptom business |
| Zdroj: | Kidney international. 60(6) |
| ISSN: | 0085-2538 |
| Popis: | Prognostic value of troponin T in hemodialysis patients is independent of comorbidity.BackgroundPatients on long-term hemodialysis have a high mortality. Various clinical and biochemical markers are of prognostic value. Cardiac troponin T (cTnT) is a sensitive and specific marker for myocardial damage. Asymptomatic dialysis patients have a high prevalence of cTnT concentrations above the diagnostic threshold for myocardial damage. There is controversy over whether this represents a false positive cTnT or an underlying pathology with a poor outcome. It is not known whether cTnT reflects comorbidity in these patients.MethodsA cohort of 73 long-term hospital hemodialysis patients had cTnT estimated once prior to a mid-week dialysis. Samples were analyzed using the second-generation cTnT assay from Boehringer Mannheim on an Elecsys 1010 analyzer. The standard diagnostic threshold for myocardial damage of 0.1 ng/mL was used. A commonly employed measure of comorbidity (Khan) was applied at the time cTnT was measured. Patients were followed for 15 months. Mortality was used as the clinical end point. Kaplan-Meier survival analysis was employed and differences between groups were assessed using the Cox-Mantel log-rank test.ResultsOf the 73 patients, 20 were positive for cTnT and 53 were negative, at the cut-off of 0.1 ng/mL. At fifteen months, 65% of the positive patients were dead, whereas only 15% of the negative patients were dead. Survival analysis confirmed that this difference was statistically significant (P < 0.00001), and that the effect of cTnT on survival was independent of comorbidity.ConclusionsThere is a high prevalence of positive cTnT in stable hemodialysis patients. A single estimation of cTnT in this group has significant prognostic value, independent of comorbidity. |
| Databáze: | OpenAIRE |
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