Interpreting Cardiac Troponin Results from High-Sensitivity Assays in Chronic Kidney Disease without Acute Coronary Syndrome
Open Access
- 1 September 2012
- journal article
- Published by Oxford University Press (OUP) in Clinical Chemistry
- Vol. 58 (9), 1342-1351
- https://doi.org/10.1373/clinchem.2012.185322
Abstract
BACKGROUND: Quantification and comparison of high-sensitivity (hs) cardiac troponin I (cTnI) and cTnT concentrations in chronic kidney disease (CKD) have not been reported. We examined the associations between hs cTnI and cTnT, cardiovascular disease, and renal function in outpatients with stable CKD. METHODS: Outpatients (n = 148; 16.9% with prior myocardial infarction or coronary revascularization) with an estimated glomerular filtration rate (eGFR) of <60 mL · min−1 · (1.73 m2)−1 had serum cTnI (99th percentile of a healthy population = 9.0 ng/L), and cTnT (99th percentile = 14 ng/L) measured with hs assays. Left ventricular ejection fraction (LVEF) and mass were assessed by echocardiography, and coronary artery calcification (CAC) was determined by computed tomography. Renal function was estimated by eGFR and urine albumin/creatinine ratio (UACR). RESULTS: The median (interquartile range) concentrations of cTnI and cTnT were 6.3 (3.4–14.4) ng/L and 17.0 (11.2–31.4) ng/L, respectively; 38% and 68% of patients had a cTnI and cTnT above the 99th percentile, respectively. The median CAC score was 80.8 (0.7–308.6), LV mass index was 85 (73–99) g/m2, and LVEF was 58% (57%–61%). The prevalences of prior coronary disease events, CAC score, and LV mass index were higher with increasing concentrations from both hs cardiac troponin assays (P < 0.05 for all). After adjustment for demographics and risk factors, neither cardiac troponin assay was associated with CAC, but both remained associated with LV mass index as well as eGFR and UACR. CONCLUSIONS: Increased hs cTnI and cTnT concentrations are common in outpatients with stable CKD and are influenced by both underlying cardiac and renal disease.Keywords
Funding Information
- Roche
- Siemens
- Critical Diagnostics
- Thermo Fisher Scientific
This publication has 27 references indexed in Scilit:
- FGF23 induces left ventricular hypertrophyJCI Insight, 2011
- High-Sensitivity Troponin T Concentrations in Acute Chest Pain Patients Evaluated With Cardiac Computed TomographyCirculation, 2010
- Analytical Validation of a High-Sensitivity Cardiac Troponin T AssayClinical Chemistry, 2010
- Increases of Cardiac Troponin in Conditions other than Acute Coronary Syndrome and Heart FailureClinical Chemistry, 2009
- Fibroblast Growth Factor 23 and Left Ventricular Hypertrophy in Chronic Kidney DiseaseCirculation, 2009
- The Relationship between Proteinuria and Coronary Risk: A Systematic Review and Meta-AnalysisPLoS Medicine, 2008
- Chronic kidney disease, prevalence of premature cardiovascular disease, and relationship to short-term mortalityAmerican Heart Journal, 2008
- Estimating GFR Using Serum Cystatin C Alone and in Combination With Serum Creatinine: A Pooled Analysis of 3,418 Individuals With CKDAmerican Journal of Kidney Diseases, 2008
- Association of Mild to Moderate Kidney Dysfunction and Coronary CalcificationJournal of the American Society of Nephrology, 2008
- Cardiac troponins in renal insufficiency: Review and clinical implicationsJournal of the American College of Cardiology, 2002