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Title: Serial increased cardiac troponin T predicts mortality in asymptomatic patients treated with chronic haemodialysis.
Austin Authors: Roberts, Matthew A;Hare, David L ;Macmillan, Neil;Ratnaike, Sujiva;Sikaris, Ken;Ierino, Francesco L
Affiliation: Department of Nephrology, Austin Health, Heidelberg 3084, Victoria, Australia
Issue Date: 19-May-2009
Publication information: Annals of Clinical Biochemistry 2009; 46(Pt 4): 291-5
Abstract: A single detectable cardiac troponin predicts mortality in patients treated with dialysis. There are limited data on changes in troponin concentration over time and the clinical implications of serial troponin measurement.Serial cardiac troponin T (cTnT) was assayed five times over 12 months in a prospective cohort study of patients with end-stage kidney disease treated with haemodialysis. A concentration of cTnT > or = 0.04 microg/L was considered increased. Mortality and cardiovascular events were analysed by survival analysis, according to the serial troponin results.From 100 patients who provided a baseline sample for cTnT, 81 completed five serial measurements. The analysis of patients who completed serial cTnT measurements demonstrated that 28 patients (35%) had normal cTnT concentrations in all five samples, 20 patients (24%) had between one and four increased cTnT measurements and 33 patients (41%) had increased concentrations of cTnT in all five samples. The 1.7-y patient survival was 100%, 90% and 78% for patients with zero, one to four, or five out of five concentrations of cTnT increased, respectively (P = 0.037), and the corresponding cardiovascular event-free survival was 100%, 91% and 78%, respectively (P = 0.027).Serial measurements of cTnT concentration were frequently increased in patients receiving haemodialysis. The number of abnormal measurements over time predicted mortality and cardiovascular adverse events.
Gov't Doc #: 19454539
DOI: 10.1258/acb.2009.008213
ORCID: 0000-0001-9554-6556
PubMed URL: 19454539
Type: Journal Article
Subjects: Adult
Disease-Free Survival
Kidney Failure, Chronic.blood.mortality.therapy
Middle Aged
Prospective Studies
Renal Dialysis.methods
Troponin T.blood
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