Haemodialysis patients longitudinally assessed by highly sensitive cardiac troponin T and commercial cardiac troponin T and cardiac troponin I assays.
BACKGROUND
Elevated cardiac troponin (cTn) concentrations predict an increased mortality in patients suffering from end-stage renal disease (ESRD). This study compares the performance of a precommercial high-sensitive cTnT assay (hs-cTnT) with two contemporary cTn assays in detecting cTn elevations in ESRD patients during a six-month follow-up.


METHODS
Thirty-two ESRD patients were followed for six months, during which cTn concentrations were assessed every two months. Baseline biomarker concentrations were compared with those in a simultaneously measured reference population of 501 healthy subjects.


RESULTS
During follow-up 26 (81%), 32 (100%) and 9 (28%) of the patients showed elevated cTn concentrations according to the current cTnT, the hs-cTnT and the cTnI assays, respectively. The range of concentrations measured in each patient had a median (interquartile range) magnitude of 0.03 microg/L (0.02-0.06), 0.017 microg/L (0.011-0.029) and 0.011 mug/L (0-0.017) according to the aforementioned assays.


CONCLUSIONS
According to the hs-cTnT assay, all of the ESRD patients had elevated cTnT concentrations at least once during the follow-up. As elevated cTn concentrations are highly prognostic of adverse events, the use of serial measurements has thus identified additional patients at risk for such events. The fact that we find cTn concentrations to be higher in patients with a history of cardiac disease is in line with this. Additional studies in ESRD patients are needed to investigate the added diagnostic and prognostic value of the very low cTnT concentrations and variations detected only by the hs-cTnT assay.
Jacobs
Leo H
LH
Department of Clinical Chemistry, University Hospital Maastricht, Maastricht 6202 AZ, the Netherlands.
van de Kerkhof
Jos
J
Mingels
Alma M
AM
Kleijnen
Vincent W
VW
van der Sande
Frank M
FM
Wodzig
Will K
WK
Kooman
Jeroen P
JP
van Dieijen-Visser
Marja P
MP
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000097:blood; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000628:therapy*; D008875:Middle Aged; D006435:Renal Dialysis / Q000379:methods*; D019210:Troponin I / Q000097:blood*; D020107:Troponin T / Q000097:blood*
D019210:Troponin I; D020107:Troponin T