Detectable baseline cardiac troponin I in asymptomatic hemodialysis patients predicted a higher rate of cardiac events at 9 months compared to negative cTnI (55.6% vs 6.3%, p=0.0007).
Cohort (n=88)
Does a detectable baseline cardiac troponin I predict future cardiac events in asymptomatic patients on chronic hemodialysis?
A single detectable cTnI in asymptomatic hemodialysis patients identifies those at high risk for future cardiac events, though serial measurements show significant fluctuations.
Absolute Event Rate: 55.6% vs 6.3%
p-value: p=0.0007
AIMS: Coronary artery disease is the major cause of death in patients with end-stage renal failure on dialysis. This study aimed to assess the predictive value of a single cardiac troponin I (cTnI), and also the kinetics of serial values. METHODS: Since cTnI is a potential biomarker of cardiac outcome, the present study examined single cTnI measurements (n = 88 patients) and its predictive value for future cardiac events, and a kinetic substudy of serial weekly cTnI measured for 8 weeks (n = 57) in a group of patients on hemodialysis. RESULTS: Single cTnI measurements: 9 patients (10.2%) had a detectable cTnI at baseline and 79 patients (89.8%) had a negative baseline cTnI. There were no significant differences in age, sex, history of ischemic heart disease, diabetes, smoking or dyslipidemia between patients with detectable and negative cTnI. At the end of 9 months, the rate of combined primary endpoints, which included myocardial infarction, cardiac death and cardiac revascularization, was significantly higher in the patients with a detectable baseline cTnI (55.6%), compared to patients with a negative cTnI (6.3%) (p = 0.0007). Serial weekly cTnI measurements: significant fluctuations in cTnI were noted over time; 27% of patients with an undetectable cTnI measured at baseline had subsequent detectable levels in the serial follow-up. CONCLUSION: A single detectable cTnI in asymptomatic patients on hemodialysis defines patients at high risk of future cardiac events. However, the incidence of detectable cTnI levels is markedly increased when serial weekly measurements are performed. The clinical significance of detectable serial measurements of cTnI is the focus of ongoing studies.
Roberts et al. (2004) conducted a cohort in End-stage renal failure on chronic hemodialysis (n=88). Detectable baseline cardiac troponin I (cTnI) vs. Negative baseline cTnI was evaluated on Combined primary endpoints including myocardial infarction, cardiac death and cardiac revascularization (p=0.0007). Detectable baseline cardiac troponin I in asymptomatic hemodialysis patients predicted a higher rate of cardiac events at 9 months compared to negative cTnI (55.6% vs 6.3%, p=0.0007).