title: Predictors of high sensitivity cardiac troponin T in chronic kidney disease patients: a cross-sectional study in the chronic renal insufficiency cohort (CRIC).
abstract: BACKGROUND
  Cardiac troponin T is independently associated with cardiovascular events and mortality in patients with chronic kidney disease (CKD). Serum levels of high sensitivity cardiac troponin T (hs-TnT) reflect subclinical myocardial injury in ambulatory patients. We sought to determine the distribution and predictors of hs-TnT in CKD patients without overt cardiovascular disease (CVD).
  
  
  METHODS
  We studied 2464 participants within the multi-ethnic Chronic Renal Insufficiency Cohort (CRIC) who did not have self-reported CVD. We considered renal and non-renal factors as potential determinants of hs-TnT, including demographics, comorbidities, left ventricular (LV) mass, serologic factors, estimated glomerular filtration rate (eGFR) and albumin to creatinine ratio.
  
  
  RESULTS
  Hs-TnT was detectable in 81% of subjects, and the median (IQR) hs-TnT was 9.4 pg/ml (4.3-18.3). Analysis was performed using Tobit regression, adjusting for renal and non-renal factors. After adjustment, lower eGFR was associated with higher expected hs-TnT; participants with eGFR < 30 ml/min/1.73 m(2) had 3-fold higher expected hs-TnT compared to subjects with eGFR > 60. Older age, male gender, black race, LV mass, diabetes and higher blood pressure all had strong, independent associations with higher expected hs-TnT.
  
  
  CONCLUSIONS
  Knowledge of the determinants of hs-TnT in this cohort may guide further research on the pathology of heart disease in patients with CKD and help to stratify sub-groups of CKD patients at higher cardiovascular risk.
authors.affiliation: San Francisco VA Medical Center, University of California San Francisco, 4150 Clement Street, Box 111A1, San Francisco, CA 94121, USA. ruth.dubin@ucsf.edu.
authors.forename: Ruth F
authors.initials: RF
authors.lastname: Dubin
authors.forename: Yongmei
authors.initials: Y
authors.lastname: Li
authors.forename: Jiang
authors.initials: J
authors.lastname: He
authors.forename: Bernard G
authors.initials: BG
authors.lastname: Jaar
authors.forename: Radhakrishna
authors.initials: R
authors.lastname: Kallem
authors.forename: James P
authors.initials: JP
authors.lastname: Lash
authors.forename: Gail
authors.initials: G
authors.lastname: Makos
authors.forename: Sylvia E
authors.initials: SE
authors.lastname: Rosas
authors.forename: Elsayed Z
authors.initials: EZ
authors.lastname: Soliman
authors.forename: Ray R
authors.initials: RR
authors.lastname: Townsend
authors.forename: Wei
authors.initials: W
authors.lastname: Yang
authors.forename: Alan S
authors.initials: AS
authors.lastname: Go
authors.forename: Martin
authors.initials: M
authors.lastname: Keane
authors.forename: Christopher
authors.initials: C
authors.lastname: Defilippi
authors.forename: Rakesh
authors.initials: R
authors.lastname: Mishra
authors.forename: Myles
authors.initials: M
authors.lastname: Wolf
authors.forename: Michael G
authors.initials: MG
authors.lastname: Shlipak
mesh_terms: D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood* / Q000175:diagnosis / Q000401:mortality*; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D051436:Renal Insufficiency, Chronic / Q000097:blood* / Q000175:diagnosis / Q000401:mortality*; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D015996:Survival Rate; D020107:Troponin T / Q000097:blood*; D014481:United States / Q000453:epidemiology
chemical_list: D015415:Biomarkers; D020107:Troponin T