BACKGROUND: Patients with end-stage renal disease have a high risk of premature death, which is due mainly to cardiovascular (CV) events. Elevated cardiac troponin T (cTnT) is related to increased left ventricular mass index (LVMI) and predicts poor outcome in chronic haemodialysis patients. We investigated the prognostic value of cTnT and its relationship with left ventricular mass in continuous ambulatory peritoneal dialysis (CAPD) patients. METHODS: Sixty-five CAPD patients (mean age: 56+/-12 years; 36% males) with no evidence of acute coronary syndrome in 28 days prior to the study were examined prospectively. After 48 months of follow-up, we evaluated total and CV mortality. RESULTS: During follow-up, 23 patients (35%) died (70% CV causes, 22% infection, 4% tumour, 4% unknown). In univariate analysis, concentrations of cTnT >/=0.035 ng/ml, increased LVMI, diabetes, serum albumin and age were all strong predictors of total mortality. In multivariate logistic regression analysis, cTnT >/=0.035 ng/ml and age independently predicted total mortality [odds ratio (OR): 4.31; 95% confidence interval (95% CI): 1.16-16.04; P = 0.008 and OR: 1.08; 95% CI: 1.02-1.15; P = 0.002, respectively]. cTnT level >/=0.035 ng/ml was the only independent predictor of CV mortality in multivariate logistic regression analysis (OR: 8.94; 95% CI: 2.23-35.88; P<0.005). There was a significant positive correlation between serum cTnT level and LVMI (rho = 0.41; P<0.002). Neither cTnI, CK nor CK-MB were related to total or CV mortality. CONCLUSIONS: Elevated serum cTnT but not cTnI predicted total and CV mortality in CAPD patients. Elevated cTnT levels were also associated with increased LVMI.
BACKGROUND:Patients with end-stage renal disease have a high risk of premature death, which is due mainly to cardiovascular (CV) events. Elevated cardiac troponin T (cTnT) is related to increased left ventricular mass index (LVMI) and predicts poor outcome in chronic haemodialysis patients. We investigated the prognostic value of cTnT and its relationship with left ventricular mass in continuous ambulatory peritoneal dialysis (CAPD) patients. METHODS: Sixty-five CAPD patients (mean age: 56+/-12 years; 36% males) with no evidence of acute coronary syndrome in 28 days prior to the study were examined prospectively. After 48 months of follow-up, we evaluated total and CV mortality. RESULTS: During follow-up, 23 patients (35%) died (70% CV causes, 22% infection, 4% tumour, 4% unknown). In univariate analysis, concentrations of cTnT >/=0.035 ng/ml, increased LVMI, diabetes, serum albumin and age were all strong predictors of total mortality. In multivariate logistic regression analysis, cTnT >/=0.035 ng/ml and age independently predicted total mortality [odds ratio (OR): 4.31; 95% confidence interval (95% CI): 1.16-16.04; P = 0.008 and OR: 1.08; 95% CI: 1.02-1.15; P = 0.002, respectively]. cTnT level >/=0.035 ng/ml was the only independent predictor of CV mortality in multivariate logistic regression analysis (OR: 8.94; 95% CI: 2.23-35.88; P<0.005). There was a significant positive correlation between serum cTnT level and LVMI (rho = 0.41; P<0.002). Neither cTnI, CK nor CK-MB were related to total or CV mortality. CONCLUSIONS: Elevated serum cTnT but not cTnI predicted total and CV mortality in CAPD patients. Elevated cTnT levels were also associated with increased LVMI.
Authors: Rakesh K Mishra; Yongmei Li; Christopher DeFilippi; Michael J Fischer; Wei Yang; Martin Keane; Jing Chen; Jiang He; Radhakrishna Kallem; Edward J Horwitz; Mohammad Rafey; Dominic S Raj; Alan S Go; Michael G Shlipak Journal: Am J Kidney Dis Date: 2013-01-04 Impact factor: 8.860
Authors: Kelsey Smith; Christopher deFilippi; Tamara Isakova; Orlando M Gutiérrez; Karen Laliberte; Stephen Seliger; Walter Kelley; Show-Hong Duh; Michael Hise; Robert Christenson; Myles Wolf; James Januzzi Journal: Am J Kidney Dis Date: 2012-08-09 Impact factor: 8.860
Authors: Joanna Leigh Dunlop; Alain Charles Vandal; Janak Rashme de Zoysa; Ruvin Sampath Gabriel; Lukas Mathias Gerber; Imad Adbi Haloob; Christopher John Hood; John Hamilton Irvine; Philip James Matheson; David Owen Ross McGregor; Kannaiyan Samuel Rabindranath; John Benedict William Schollum; David John Semple; Mark Roger Marshall Journal: BMC Nephrol Date: 2014-07-21 Impact factor: 2.388