Elevated cardiac troponin T predicts cardiovascular events in asymptomatic continuous ambulatory peritoneal dialysis patients without a history of cardiovascular disease

Am J Nephrol. 2009;29(2):129-35. doi: 10.1159/000151634. Epub 2008 Aug 22.

Abstract

Background: Recent studies revealed that elevated cardiac troponin T (cTnT) could predict all-cause mortality and cardiovascular diseases in end-stage renal disease patients. This study aimed to evaluate cTnT as a prognostic value in asymptomatic continuous ambulatory peritoneal dialysis patients.

Methods: This is a prospective observational study with 107 prevalent peritoneal dialysis patients. cTnT, high-sensitive C-reactive protein (hsCRP) and IL-6 were measured at baseline. Based on cTnT level, patients were classified as higher cTnT group (HT, n = 21, cTnT > or =0.1 ng/ml) and lower cTnT group (LT, n = 86, cTnT <0.1 ng/ml), and were followed for 3 years. Primary endpoint was cardiovascular events.

Results: The HT group had a significantly higher level of log hsCRP and log IL-6 than the LT group (p < 0.05). Kaplan-Meier survival demonstrated worse cardiovascular event-free survival for the HT group. Multivariate analysis adjusted for age, cTnT, IL-6 and hsCRP level revealed that age (per 1-year increase, HR 1.07, p < 0.05), elevated cTnT (vs. <0.1 ng/ml, HR 5.89, p < 0.05) and hsCRP (vs. <3.0 mg/l, HR 4.15, p < 0.05) were identified as significant determinants of cardiovascular events.

Conclusion: This study suggests that cTnT may be an aid in risk stratification of continuous ambulatory peritoneal dialysis patients.

MeSH terms

  • Adult
  • Biomarkers / blood
  • C-Reactive Protein / metabolism
  • Cardiovascular Diseases / blood*
  • Cardiovascular Diseases / mortality*
  • Female
  • Follow-Up Studies
  • Humans
  • Interleukin-6 / blood
  • Kaplan-Meier Estimate
  • Kidney Failure, Chronic / blood*
  • Kidney Failure, Chronic / mortality*
  • Kidney Failure, Chronic / therapy
  • Male
  • Middle Aged
  • Peritoneal Dialysis, Continuous Ambulatory / statistics & numerical data*
  • Predictive Value of Tests
  • Prevalence
  • Prospective Studies
  • Risk Factors
  • Troponin T / blood*

Substances

  • Biomarkers
  • IL6 protein, human
  • Interleukin-6
  • Troponin T
  • C-Reactive Protein