Consistently increased serial cardiac troponin T over 12 months predicted lower 1.7-year survival (78% vs 100% for zero increased measurements, P=0.037) in patients receiving hemodialysis.
Cohort (n=100)
Does the number of serially increased cardiac troponin T measurements predict mortality and cardiovascular events in asymptomatic patients on chronic haemodialysis?
Serial measurements of cTnT in asymptomatic hemodialysis patients frequently show elevations, and the frequency of these elevations strongly predicts mortality and cardiovascular events.
Absolute Event Rate: 78% vs 100%
p-value: p=0.037
BACKGROUND: A single detectable cardiac troponin predicts mortality in patients treated with dialysis. There are limited data on changes in troponin concentration over time and the clinical implications of serial troponin measurement. METHODS: Serial cardiac troponin T (cTnT) was assayed five times over 12 months in a prospective cohort study of patients with end-stage kidney disease treated with haemodialysis. A concentration of cTnT > or = 0.04 microg/L was considered increased. Mortality and cardiovascular events were analysed by survival analysis, according to the serial troponin results. RESULTS: From 100 patients who provided a baseline sample for cTnT, 81 completed five serial measurements. The analysis of patients who completed serial cTnT measurements demonstrated that 28 patients (35%) had normal cTnT concentrations in all five samples, 20 patients (24%) had between one and four increased cTnT measurements and 33 patients (41%) had increased concentrations of cTnT in all five samples. The 1.7-y patient survival was 100%, 90% and 78% for patients with zero, one to four, or five out of five concentrations of cTnT increased, respectively (P = 0.037), and the corresponding cardiovascular event-free survival was 100%, 91% and 78%, respectively (P = 0.027). CONCLUSIONS: Serial measurements of cTnT concentration were frequently increased in patients receiving haemodialysis. The number of abnormal measurements over time predicted mortality and cardiovascular adverse events.
Roberts et al. (2009) conducted a cohort in End-stage kidney disease treated with haemodialysis (n=100). Serial increased cardiac troponin T (≥ 0.04 μg/L) vs. Normal cardiac troponin T concentrations was evaluated on 1.7-year patient survival (p=0.037). Consistently increased serial cardiac troponin T over 12 months predicted lower 1.7-year survival (78% vs 100% for zero increased measurements, P=0.037) in patients receiving hemodialysis.
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