Elevated cardiac troponin T is associated with increased left ventricular mass index and predicts mortality in continuous ambulatory peritoneal dialysis patients.
BACKGROUND
Patients with end-stage renal disease have a high risk of premature death, which is due mainly to cardiovascular (CV) events. Elevated cardiac troponin T (cTnT) is related to increased left ventricular mass index (LVMI) and predicts poor outcome in chronic haemodialysis patients. We investigated the prognostic value of cTnT and its relationship with left ventricular mass in continuous ambulatory peritoneal dialysis (CAPD) patients.


METHODS
Sixty-five CAPD patients (mean age: 56+/-12 years; 36% males) with no evidence of acute coronary syndrome in 28 days prior to the study were examined prospectively. After 48 months of follow-up, we evaluated total and CV mortality.


RESULTS
During follow-up, 23 patients (35%) died (70% CV causes, 22% infection, 4% tumour, 4% unknown). In univariate analysis, concentrations of cTnT >/=0.035 ng/ml, increased LVMI, diabetes, serum albumin and age were all strong predictors of total mortality. In multivariate logistic regression analysis, cTnT >/=0.035 ng/ml and age independently predicted total mortality [odds ratio (OR): 4.31; 95% confidence interval (95% CI): 1.16-16.04; P = 0.008 and OR: 1.08; 95% CI: 1.02-1.15; P = 0.002, respectively]. cTnT level >/=0.035 ng/ml was the only independent predictor of CV mortality in multivariate logistic regression analysis (OR: 8.94; 95% CI: 2.23-35.88; P<0.005). There was a significant positive correlation between serum cTnT level and LVMI (rho = 0.41; P<0.002). Neither cTnI, CK nor CK-MB were related to total or CV mortality.


CONCLUSIONS
Elevated serum cTnT but not cTnI predicted total and CV mortality in CAPD patients. Elevated cTnT levels were also associated with increased LVMI.
Duman
Dursun
D
Haydarpasa Numune Training and Research Hospital, Department of Cardiology, Ahmet Refik Sok. Ceylan Apt. 19/5, Ciftehavuzlar, 81060 Istanbul, Turkey. drduman@excite.com
Tokay
Sena
S
Toprak
Ahmet
A
Duman
Deniz
D
Oktay
Ahmet
A
Ozener
Ishak Cetin
IC
Unay
Ozlem
O
D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000401:mortality*; D005260:Female; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000737:chemistry*; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects*; D011379:Prognosis; D011446:Prospective Studies; D020107:Troponin T / Q000097:blood*
D020107:Troponin T