title: Clinical significance of cardiac troponin T levels in chronic kidney disease patients: predictive value for cardiovascular risk.
abstract: BACKGROUND
  Recent studies have shown that cardiac troponin T (cTnT) levels predict cardiovascular mortality in hemodialysis patients. The aim of this study is to analyze the prognostic value of cTnT levels in stable patients with moderate chronic kidney disease (CKD).
  
  
  METHODS
  One hundred seventy-six outpatients were included; 128 patients had an estimated glomerular filtration rate (GFR) less than 60 mL/min (<1 mL/s; CKD group), and 48 patients, 60 mL/min or greater (> or =1 mL/s; control group). Medical records for cardiovascular factors were recorded. Analytical parameters and cardiac markers were analyzed. Patients were followed up prospectively, and the end points were fatal and nonfatal cardiovascular events.
  
  
  RESULTS
  cTnT levels were undetectable in all control group patients (cTnT < 0.01 ng/mL), and only 20 patients in the CKD group had detectable values (>0.01 ng/mL). Patients with detectable cTnT levels were older (P = 0.005), had a greater prevalence of congestive heart failure (CHF; P = 0.000) and left ventricular hypertrophy (P = 0.001), more anemia (P = 0.008), and a lower GFR (P = 0.008) than the rest of the patients in the CKD group. After a mean follow-up of 12.9 months, 20 patients in the CKD group and 1 patient in the control group experienced a cardiovascular event. Age (odds ratio [OR], 1.11), previous coronary artery disease (OR, 2.49), CHF (OR, 7.36), hemoglobin level (OR, 0.70), GFR (OR, 0.94), pulse pressure (OR, 1.02), and cTnT level (OR, 12.34) predicted cardiovascular events on univariate Cox analysis.
  
  
  CONCLUSIONS
  In patients with CKD, cTnT level is a predictor of cardiovascular events.
authors.affiliation: S Nefrologa y Bioqumica, Department of Nephrology, Hospital General Universitario Gregorio Marañon, Madrid, Spain. albvia@teleline.es
authors.forename: Marian
authors.initials: M
authors.lastname: Goicoechea
authors.forename: Soledad
authors.initials: S
authors.lastname: Garca de Vinuesa
authors.forename: Francisco
authors.initials: F
authors.lastname: Gómez-Campderá
authors.forename: Maria José
authors.initials: MJ
authors.lastname: Gutierrez
authors.forename: Paula
authors.initials: P
authors.lastname: Blanco
authors.forename: Raquel
authors.initials: R
authors.lastname: Amann
authors.forename: José
authors.initials: J
authors.lastname: Luño
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000097:blood* / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D012307:Risk Factors; D020107:Troponin T / Q000097:blood*
chemical_list: D015415:Biomarkers; D020107:Troponin T