Elevated cardiac troponin T predicts cardiovascular events in asymptomatic continuous ambulatory peritoneal dialysis patients without a history of cardiovascular disease.
BACKGROUND
Recent studies revealed that elevated cardiac troponin T (cTnT) could predict all-cause mortality and cardiovascular diseases in end-stage renal disease patients. This study aimed to evaluate cTnT as a prognostic value in asymptomatic continuous ambulatory peritoneal dialysis patients.


METHODS
This is a prospective observational study with 107 prevalent peritoneal dialysis patients. cTnT, high-sensitive C-reactive protein (hsCRP) and IL-6 were measured at baseline. Based on cTnT level, patients were classified as higher cTnT group (HT, n = 21, cTnT > or =0.1 ng/ml) and lower cTnT group (LT, n = 86, cTnT <0.1 ng/ml), and were followed for 3 years. Primary endpoint was cardiovascular events.


RESULTS
The HT group had a significantly higher level of log hsCRP and log IL-6 than the LT group (p < 0.05). Kaplan-Meier survival demonstrated worse cardiovascular event-free survival for the HT group. Multivariate analysis adjusted for age, cTnT, IL-6 and hsCRP level revealed that age (per 1-year increase, HR 1.07, p < 0.05), elevated cTnT (vs. <0.1 ng/ml, HR 5.89, p < 0.05) and hsCRP (vs. <3.0 mg/l, HR 4.15, p < 0.05) were identified as significant determinants of cardiovascular events.


CONCLUSIONS
This study suggests that cTnT may be an aid in risk stratification of continuous ambulatory peritoneal dialysis patients.
Han
Seung Hyeok
SH
Department of Internal Medicine, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-gu, Seoul, Korea.
Choi
Hoon Young
HY
Kim
Dong Ki
DK
Moon
Sung Jin
SJ
Lee
Jung Eun
JE
Yoo
Tae Hyun
TH
Kim
Beom Seok
BS
Kang
Shin-Wook
SW
Choi
Kyu Hun
KH
Lee
Ho Yung
HY
Han
Dae-Suk
DS
D000328:Adult; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000097:blood* / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000401:mortality* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000706:statistics & numerical data*; D011237:Predictive Value of Tests; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D020107:Troponin T / Q000097:blood*
D015415:Biomarkers; C508600:IL6 protein, human; D015850:Interleukin-6; D020107:Troponin T; D002097:C-Reactive Protein