Troponin T is an independent predictor of mortality in renal transplant recipients.
BACKGROUND
Numerous reports have demonstrated an association between elevated Troponin T levels and adverse cardiovascular outcomes in patients with chronic kidney disease. However, whether raised Troponin T levels are an independent predictor of mortality in renal transplant recipients has not yet been established. The aim of this study was, therefore, to assess the use of Troponin T as a prognostic marker in a population of renal transplant recipients.


METHODS
Three hundred and seventy-two asymptomatic renal transplant recipients were recruited between June 2000 and December 2002. Troponin T was measured at baseline and prospective follow-up data were collected at a median of 1739 days.


RESULTS
In Kaplan-Meier analysis a Troponin T level > or = 0.03 microg/l was a significant predictor of mortality (P < 0.001). In Cox Regression analysis, an elevated Troponin T level remained a significant predictor of mortality following adjustment for traditional cardiovascular risk factors (P < 0.001) and following adjustment for estimated glomerular filtration rate and high sensitivity C reactive protein (P < 0.001).


CONCLUSIONS
Elevated Troponin T level is a strong independent predictor of all cause mortality in patients with a renal transplant. Troponin T, therefore, represents a promising biochemical marker that identifies those renal transplant recipients who are most likely to benefit from aggressive cardiovascular risk factor modification.
Department of Clinical Biochemistry, Royal Victoria Hospital, Grosvenor Road, Belfast, Northern Ireland BT12 6BA, UK. Grainne.Connolly@bll.n-i.nhs.uk
Grainne M
GM
Connolly
Ronan
R
Cunningham
Peter T
PT
McNamee
Ian S
IS
Young
Alexander P
AP
Maxwell
D000328:Adult; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000209:etiology / Q000401:mortality / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D016030:Kidney Transplantation / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012044:Regression Analysis; D051437:Renal Insufficiency / Q000150:complications / Q000601:surgery; D012307:Risk Factors; D012680:Sensitivity and Specificity; D020107:Troponin T / Q000097:blood*
D015415:Biomarkers; D020107:Troponin T