Clinical significance of cardiac troponin T levels in chronic kidney disease patients: predictive value for cardiovascular risk.
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.
Goicoechea
Marian
M
S Nefrologa y Bioqumica, Department of Nephrology, Hospital General Universitario Gregorio Marañon, Madrid, Spain. albvia@teleline.es
Garca de Vinuesa
Soledad
S
Gómez-Campderá
Francisco
F
Gutierrez
Maria José
MJ
Blanco
Paula
P
Amann
Raquel
R
Luño
José
J
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*
D015415:Biomarkers; D020107:Troponin T