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Elevated cardiac troponin T in predialysis patients is associated with inflammation and predicts mortality

C Löwbeer1, P Stenvinkel, R Pecoits-Filho

  • 1Division of Clinical Chemistry, Department of Medical Laboratory Sciences and Technology, Karolinska Institutet at Huddinge University Hospital, Stockholm, Sweden. christian.lowbeer@medilab.se

Journal of Internal Medicine
|January 25, 2003
PubMed

Insights

Elevated cardiac troponin T (cTnT) levels in predialysis patients predict mortality. Higher cTnT also correlates with inflammation markers like IL-6 and CRP, indicating its role in end-stage renal disease prognosis.

Area of Science:

  • Cardiology
  • Nephrology
  • Biomarkers

Background:

  • Cardiac troponin T (cTnT) is a sensitive marker of myocardial damage.
  • Elevated cTnT in hemodialysis patients is linked to poor outcomes.
  • The prognostic value of cTnT in predialysis patients and its association with inflammatory markers require further investigation.

Purpose of the Study:

  • To evaluate the predictive value of cTnT in patients before starting dialysis.
  • To examine the relationship between cTnT and inflammatory markers, including C-reactive protein (CRP) and interleukin-6 (IL-6).

Main Methods:

  • A cohort follow-up study involving 115 end-stage renal disease (ESRD) patients.
  • Analysis of cTnT using a third-generation assay.
  • Survival analysis using Kaplan-Meier and Cox regression, with all-cause mortality as the endpoint.

Main Results:

  • Serum cTnT correlated positively with CKMB, IL-6, and CRP, and negatively with serum albumin.
  • Diabetic patients and those with cardiovascular disease (CVD) had significantly higher cTnT levels.
  • Patients with cTnT ≥ 0.10 μg/L had higher cumulative mortality.
  • Diabetes Mellitus (DM) and cTnT were independently associated with mortality in multivariate analysis.

Conclusions:

  • Serum cTnT ≥ 0.10 μg/L is a significant predictor of mortality in patients initiating dialysis.
  • Positive correlations between cTnT and inflammatory markers suggest an association between inflammation and cTnT levels.
  • cTnT is an independent predictor of mortality in ESRD patients commencing dialysis.
Abstract

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