Key result
Lower eGFR linked to reduced hs-cTn prognostic value for mortality, requiring ~5-20-fold higher cutoffs.
Why the study?
Kidney function influences cardiac troponin T and I concentrations, prompting investigation into how this affects their prognostic ability.
Does kidney function affect the prognostic ability and optimal cutoff concentrations of high-sensitivity cardiac troponin for 30-day mortality?
Cohort
Yes
Does kidney function affect the prognostic ability and optimal cutoff concentrations of high-sensitivity cardiac troponin for 30-day mortality?
Kidney function significantly affects the prognostic performance of high-sensitivity cardiac troponins, requiring higher optimal cutoff concentrations for patients with lower eGFR.
Answers are grounded in this paper and cite their sources.
eGFR attenuates hs-cTn prognostic value for 30-day mortality; supports exploring adjusted cutoffs but leaves open prospective validation before practice change.
BACKGROUND: Kidney function influences the concentration of cardiac troponin T (cTnT) and I (cTnI). We investigate how this impacts their prognostic ability. METHODS: This Danish nationwide study included patients from 2013 to 2023 with at least two measurements of Roche hs-cTnT, Abbott hs-cTnI, or Siemens hs-cTnI Vista or Atellica during the index admission. Patients were stratified by estimated glomerular filtration rate (eGFR). We assessed prognostic ability by Cox models and area under the receiver operating characteristics curve (AUC). The primary endpoint was 30-day all-cause mortality. RESULTS: the optimal cutoff was 16.5 ng/l for hs-cTnT and below the sex-specific 99th percentile for all hs-cTnI assays, increasing 5-20-fold with lower eGFR for all assays. CONCLUSION: Kidney function affects cTn prognostic performance, with reduced predictive ability and higher optimal cutoff concentrations for lower eGFR.
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Hasselbalch et al. (2025) conducted a cohort in Patients with cardiac troponin measurements. High-sensitivity cardiac troponin (hs-cTnT and hs-cTnI) vs. Stratified by estimated glomerular filtration rate (eGFR) was evaluated on 30-day all-cause mortality. Lower estimated glomerular filtration rate reduced the prognostic ability of high-sensitivity cardiac troponin for 30-day mortality, requiring optimal cutoff concentrations to increase 5-20-fold.
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