In clinically stable dialysis patients, high serum cardiac troponin-I was significantly associated with higher left ventricular mass index (Beta 31.60) and lower ejection fraction, whereas troponin-T was not.
Cross-Sectional (n=154)
Outcome assessors blinded to laboratory results
No
Does serum cTnI or cTnT better indicate left ventricular dysfunction and coronary artery disease in clinically stable dialysis patients?
In clinically stable dialysis patients, cTnI is a superior biomarker for left ventricular dysfunction (LVMI and LVEF), whereas cTnT is better suited for detecting coronary artery disease.
Effect estimate: Beta 31.60
p-value: p=0.001
BACKGROUND: Serum troponin assays, widely used to detect acute cardiac ischemia, might be useful biomarkers to detect chronic cardiovascular disease (CVD). Cardiac-specific troponin-I (cTnI) and troponin-T (cTnT) generally detect myocardial necrosis equally well. In dialysis patients however, serum cTnT levels are often elevated, unlike cTnI levels. The present study aims to elucidate the associations of cTnI and cTnT with CVD in clinically stable dialysis patients. METHODS: Troponin levels were measured using 5th generation hs-cTnT assays (Roche) and STAT hs-cTnI assays (Abbott) in a cohort of dialysis patients. Serum troponin levels were divided into tertiles with the lowest tertile as a reference value. Serum troponins were associated with indicators of CVD such as left ventricular mass index (LVMI), left ventricular ejection fraction (LVEF) and the presence of coronary artery disease (CAD). Associations were explored using regression analysis. RESULTS: We included 154 consecutive patients, 68±7 years old, 77% male, 70% hemodialysis. Median serum cTnT was 51ng/L (exceeding the 99th percentile of the healthy population in 98%) and median serum cTnI was 13ng/L (elevated in 20%). A high cTnI (T3) was significantly associated with a higher LVMI (Beta 31.60; p=0.001) and LVEF (Beta -4.78; p=0.005) after adjusting for confounders whereas a high serum cTnT was not. CAD was significantly associated with a high cTnT (OR 4.70 p=0.02) but not with a high cTnI. Unlike cTnI, cTnT was associated with residual renal function (Beta:-0.09; p=0.006). CONCLUSION: In the present cohort, serum cTnI levels showed a stronger association with LVMI and LVEF than cTnT. However, cTnT was significantly associated with CAD and residual renal function, unlike cTnI. Therefore, cTnI seems to be superior to cTnT as a marker of left ventricular dysfunction in asymptomatic dialysis patients, while cTnT might be better suited to detect CAD in these patients.
Buiten et al. (Mon,) conducted a cross-sectional in End-Stage Renal Disease (ESRD) (n=154). High serum cardiac troponin-I (cTnI) and troponin-T (cTnT) vs. Lowest tertile (T1) of respective troponins was evaluated on Left Ventricular Mass Index (LVMI) (Beta 31.60, p=0.001). In clinically stable dialysis patients, high serum cardiac troponin-I was significantly associated with higher left ventricular mass index (Beta 31.60) and lower ejection fraction, whereas troponin-T was not.