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Cardiac troponin I (2nd generation assay) in chronic haemodialysis patients: prevalence and prognostic value
Marta Beciani1, Angela Tedesco, Anneo Violante
1Chemical Laboratory, Aurelia Hospital, Rome, Italy.
Insights
Elevated cardiac troponin I (cTnI) levels predict cardiac events in asymptomatic dialysis patients. Monitoring cTnI can help identify high-risk individuals for timely intervention and improved cardiovascular outcomes.
Area of Science:
- Nephrology
- Cardiology
- Clinical Diagnostics
Background:
- Elevated cardiac troponin T (cTnT) is common in dialysis patients, linked to poor outcomes.
- The clinical significance of cardiac troponin I (cTnI) in this population is less understood.
Purpose of the Study:
- To investigate the predictive value of serum cTnI for cardiovascular events in asymptomatic chronic dialysis patients.
- To compare the clinical significance of cTnI with existing markers like cTnT.
Main Methods:
- 101 asymptomatic dialysis patients were monitored for 12 months.
- Serum cTnI levels were measured using a second-generation assay.
- Regular clinical, X-ray, and echocardiographic surveillance was conducted.
Main Results:
- Patients with high cTnI (> or =0.15 ng/ml) had a 64% rate of acute cardiac events.
- Patients with low cTnI (<0.15 ng/ml) had a 9.7% event rate.
- Patients with variable cTnI levels had a 20% event rate.
Conclusions:
- Serum cTnI is a significant predictor of cardiovascular events in asymptomatic dialysis patients.
- Measuring cTnI can aid in identifying patients who may benefit from cardiac investigation and treatment.
- This marker could be crucial for preventing cardiac events in this vulnerable population.
Background:
Elevated serum cardiac troponin T (cTnT) levels are frequently observed in chronic dialysis patients and have been shown to be associated with increased morbidity and mortality. The aim of this study was to determine whether cardiac troponin I (cTnI), which is less frequently elevated, has similar clinical significance.
Methods:
We studied 101 asymptomatic patients with no clinical evidence of coronary artery disease who were undergoing chronic dialytic treatment. We measured their serum cTnI levels immediately before the start of their dialysis sessions by a second-generation assay (OPUS-DADE). Our study included a year-long follow-up with trimestrial cTnI assays as well as clinical, X-ray and echocardiographic surveillance. We considered patients with serum cTnI > or =0.15 ng/ml as positive and those with levels <0.15 ng/ml as negative.
Results:
Among the 14 patients with high serum cTnI levels, nine (64%) suffered acute cardiac events during the 12-month follow-up. In contrast, among the 72 patients with low cTnI levels only seven (9.7%) had acute events. In another group of 15 patients with variable cTnI levels, three patients (20%) had cardiac events.
Conclusion:
Based on these results, serum cTnI appears to be a valuable predictive marker of cardiovascular events in asymptomatic dialysis patients. For those patients who might benefit from thorough cardiac investigation and treatment, information on cTnI could be useful in preventing cardiac events.
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