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Cardiac troponin‐I and its prognostic significance in a dialysis population
Author(s) -
Hussein Magdi,
Mooij Jaap,
Roujouleh Haysam,
AL Shenawi Omer
Publication year - 2004
Publication title -
hemodialysis international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.658
H-Index - 47
eISSN - 1542-4758
pISSN - 1492-7535
DOI - 10.1111/j.1492-7535.2004.80406.x
Subject(s) - medicine , hemodialysis , dialysis , myocardial infarction , asymptomatic , cardiology , diabetes mellitus , ejection fraction , troponin , population , creatine kinase , heart failure , endocrinology , environmental health
Background: The objective was to study the prevalence and specificity of elevated levels of cardiac troponin‐I (cT‐I) in patients on maintenance hemodialysis in relation to creatine kinase (CK), the CK‐MB fraction, and the ratio CK‐MB of total CK and to assess its significance for the long‐term prognosis in these patients, compared to other parameters known to influence the outcome. Methods: Predialysis blood samples were taken from 93 asymptomatic hemodialysis patients for cT‐I, total CK, the CK‐MB fraction, and the ratio of CK‐MB to total CK. cT‐I was measured by a microparticle enzyme immunoassay. The patients were followed for 1 year, after which baseline levels of cT‐I and age, duration of dialysis, and the presence of diabetes mellitus and ischemic heart disease were correlated by linear regression analysis with the outcome parameter all‐cause mortality. Results: None of the patients had a cT‐I level higher than the manufacturer's indicated cutoff point of 2.0 ng/mL for myocardial infarction, indicating a specificity of 100%. Nine of the 93 patients (9.7%) had detectable cT‐I levels (>0.0 ng/mL). Twelve patients died within 1 year, among which 4 had baseline cT‐I levels above 0 ng/mL. From the study variables, an elevated baseline cT‐I was found to be the only factor that significantly correlated with the outcome all‐cause mortality (p = 0.029). Conclusions: cT‐I has a high specificity for the diagnosis of myocardial infarction in dialysis patients. Despite the relatively low number of positive test results, cT‐I was found to be significantly correlated with the outcome all‐cause mortality at 1 year.