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Hemodialysis and biomarkers of myocardial infarction - a cohort study

Rasmus Bo Hasselbalch1,2, Bashir Alaour3, Jonas Henrik Kristensen1,2

  • 1Department of Cardiology, Copenhagen University Hospital - Herlev and Gentofte Hospital, Copenhagen, Denmark.

Clinical Chemistry and Laboratory Medicine
|August 9, 2023
PubMed

Insights

High-sensitivity cardiac troponin T (hs-cTnT) and I (hs-cTnI) predict mortality in hemodialysis patients, unlike cardiac myosin-binding protein C (cMyC). Elevated hs-cTnT and hs-cTnI levels are linked to increased mortality risk.

Area of Science:

  • Nephrology
  • Cardiology
  • Biomarkers

Background:

  • End-stage renal disease (ESRD) significantly increases cardiovascular disease (CVD) risk.
  • Hemodialysis patients exhibit elevated cardiac troponin levels, complicating risk stratification.

Purpose of the Study:

  • To compare the concentration and prognostic value of high-sensitivity cardiac troponin T (hs-cTnT), high-sensitivity cardiac troponin I (hs-cTnI), and cardiac myosin-binding protein C (cMyC) in stable hemodialysis patients.
  • To assess the association of these biomarkers with all-cause mortality and major adverse cardiovascular events.

Main Methods:

  • Prospective study of 307 stable hemodialysis patients.
  • Measurement of hs-cTnT, hs-cTnI, and cMyC levels before and after hemodialysis.
  • Cox regression analysis to evaluate the association between biomarker quartiles and clinical outcomes during follow-up.

Main Results:

  • Hs-cTnT levels were elevated above the 99th percentile in nearly all patients (99%).
  • Higher quartiles of hs-cTnT and hs-cTnI were significantly associated with increased risk of all-cause mortality and a combined endpoint of cardiovascular events and mortality.
  • Cardiac myosin-binding protein C (cMyC) concentrations were not associated with mortality or cardiovascular events.

Conclusions:

  • Hs-cTnT and hs-cTnI are valuable prognostic biomarkers in hemodialysis patients, with elevated levels indicating higher mortality risk.
  • Cardiac myosin-binding protein C (cMyC) does not appear to be a useful prognostic marker in this population.
  • These findings have implications for cardiovascular risk management in patients undergoing hemodialysis.
Abstract

Keywords:
biomarkerscardiac troponinhemodialysismyocardial infarctionrenal disease

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