Key result
In asymptomatic hemodialysis patients, hs-cTnT levels were elevated in 99.0% and increased significantly after hemodialysis, whereas hs-cTnI was elevated in 34.5% and did not significantly change.
Why the study?
Hs-cTn variation during hemodialysis and increased adverse cardiovascular events after long versus short interdialytic intervals prompted evaluating hs-cTnI and hs-cTnT variation before and after dialysis and across intervals.
Does hemodialysis and interdialytic interval length affect the levels of hs-cTnI and hs-cTnT in asymptomatic patients with ESRD?
Observational (n=200)
No
Does hemodialysis and interdialytic interval length affect the levels of hs-cTnI and hs-cTnT in asymptomatic patients with ESRD?
In asymptomatic hemodialysis patients, hs-cTnT is elevated in 99% of patients and rises significantly post-dialysis, whereas hs-cTnI is elevated in only ~34% and remains stable, suggesting hs-cTnI may be a more reliable diagnostic marker for acute myocardial infarction in this population.
hs-cTnI may be preferable for AMI diagnosis in hemodialysis patients; leaves open whether interdialytic intervals affect troponin kinetics.
Variation of high-sensitivity cardiac troponin I and T (hs-cTn) during hemodialysis has been observed. Observational studies demonstrated the increased incidence of adverse cardiovascular events after long compared to short interdialytic intervals. Therefore, we aimed to compare variation of hs-cTnI and hs-cTnT before and after hemodialysis and between short and long interdialytic intervals. We enrolled 200 asymptomatic patients receiving regular hemodialysis. The hs-cTnI and hs-cTnT levels were measured before and after hemodialysis on the day after short and long interdialytic intervals. Mean age was 62.3 ± 14.8 years (Male 55.5%). Prevalence of increased hs-cTnI and hs-cTnT was 34.5% and 99.0%, respectively. The median ± interquartile range of hs-cTnT increased significantly after hemodialysis during short and long interdialytic intervals. However, hs-cTnI level did not increase after hemodialysis during short and long intervals. We found that levels of hs-cTnI and T did not differ between short interdialytic and long interdialytic intervals. We demonstrated higher prevalence of elevated hs-cTnT in patients with regular hemodialysis compared to hs-cTnI. The rise of hs-cTnT was observed immediately after hemodialysis but no significant change of hs-cTnI was noted. Accordingly, hs-cTnI may be preferable as a diagnostic marker in patients with suspected acute myocardial infarction than hs-cTnT.
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Wongcharoen et al. (2021) conducted an observational in End-stage renal disease (ESRD) (n=200). Hemodialysis vs. Pre-hemodialysis baseline was evaluated on Median hs-cTnT level (ng/L) post-hemodialysis vs pre-hemodialysis during short interdialytic interval (p=<0.001). In asymptomatic hemodialysis patients, hs-cTnT levels were elevated in 99.0% and increased significantly after hemodialysis, whereas hs-cTnI was elevated in 34.5% and did not significantly change.
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