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Association between troponin I level and cardiovascular risk factors in asymptomatic hemodialysis patients
Shahram Taheri1, Ali Asghar Pilehvarian2, Nafiseh Akbari1
1Department of Internal Medicine, Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Insights
Cardiac troponin I (cTnI) levels were rarely elevated in asymptomatic hemodialysis (HD) patients. Significant cTnI elevation in these patients may indicate active cardiovascular disease (CVD).
Area of Science:
- Cardiology
- Nephrology
- Clinical Chemistry
Background:
- Patients undergoing hemodialysis (HD) face elevated risks of cardiovascular morbidity and mortality.
- Cardiac troponins are key biomarkers for myocardial injury, but their role in HD patients is debated.
- Assessing cardiac troponin levels in asymptomatic HD patients is crucial for understanding cardiovascular risk.
Purpose of the Study:
- To investigate the frequency and significance of cardiac troponin I (cTnI) elevation in asymptomatic hemodialysis patients.
- To explore correlations between cTnI levels and patient demographics, clinical factors, and laboratory results.
- To determine if elevated cTnI in this population is indicative of active cardiovascular disease (CVD).
Main Methods:
- A cross-sectional study enrolled 101 asymptomatic patients undergoing HD for at least 3 months.
- Blood samples for cardiac troponin I (cTnI) were collected before routine HD sessions.
- High-sensitivity assay (VIDAS troponin I Ultra) measured cTnI levels, which were then correlated with clinical and laboratory data.
Main Results:
- Only 26 out of 101 patients had cTnI levels above 0.01 ΅g/L; only two exceeded 0.11 ΅g/L.
- Fasting blood sugar showed a significant correlation with cTnI levels (r = 0.357, P = 0.0001).
- Demographic and most clinical characteristics, including diabetes and hyperlipidemia history, did not significantly correlate with cTnI levels.
Conclusions:
- Significant elevation of cTnI is infrequent in asymptomatic hemodialysis patients.
- Elevated cTnI in this cohort may serve as a potential indicator of underlying active cardiovascular disease.
- Further research is warranted to clarify the prognostic value of cTnI in hemodialysis patients.
Objective:
Patients on hemodialysis (HD) have a high risk for cardiovascular morbidity and mortality. Cardiac troponins are biomarkers for diagnosing acute myocardial injury or infarction. There is considerable controversy that exists in the frequency and significance of cardiac troponins in predicting cardiac injury and ischemia in HD patients.
Methods:
In this cross-sectional study, all HD patients more than 18-year-old, who were at least 3 months under HD, and had no sign and symptom of active cardiovascular disease (CVD), in two HD centers were enrolled. One hundred and one patients fulfilled the inclusion criteria. Blood sample for cardiac troponin I (cTnI) was drown before the initiation of HD session during their routine monthly blood testing from patients' vascular access arterial line. cTnI levels were measured by a high-sensitivity assay, VIDAS troponin I Ultra kit, and correlated with patients' demographic, clinical, and laboratory results.
Findings:
The patients' different demographic and clinical characteristics had no statistically significant correlation with troponin levels except for marginal trend for past medical history of diabetes and hyperlipidemia with corresponding P values of 0.072 and 0.055. Twenty-six patients had cTnI level more than 0.01 ΅g/L and only two patients had cTnI level more than 0.11 ΅g/L. For laboratory results, only fasting blood sugar had statistically significant correlation with patients' cTnI level (r = 0.357, P = 0.0001).
Conclusion:
Frequency of significant elevation of cTnI level in our asymptomatic HD patients was very low and if such elevation is found in this population, it may be considered as a sign of active CVD.
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