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- Title
Predictors of high sensitivity cardiac troponin T in chronic kidney disease patients: a cross-sectional study in the chronic renal insufficiency cohort (CRIC).
- Authors
Dubin, Ruth F.; Yongmei Li; Jiang He; Jaar, Bernard G.; Kallem, Radhakrishna; Lash, James P.; Makos, Gail; Rosas, Sylvia E.; Soliman, Elsayed Z.; Townsend, Ray R.; Wei Yang; Go, Alan S.; Keane, Martin; deFilippi, Christopher; Mishra, Rakesh; Wolf, Myles; Shlipak, Michael G.
- Abstract
Background Cardiac troponin T is independently associated with cardiovascular events and mortality in patients with chronic kidney disease (CKD). Serum levels of high sensitivity cardiac troponin T (hs-TnT) reflect subclinical myocardial injury in ambulatory patients. We sought to determine the distribution and predictors of hs-TnT in CKD patients without overt cardiovascular disease (CVD). Methods We studied 2464 participants within the multi-ethnic Chronic Renal Insufficiency Cohort (CRIC) who did not have self-reported CVD. We considered renal and non-renal factors as potential determinants of hs-TnT, including demographics, comorbidities, left ventricular (LV) mass, serologic factors, estimated glomerular filtration rate (eGFR) and albumin to creatinine ratio. Results Hs-TnT was detectable in 81% of subjects, and the median (IQR) hs-TnT was 9.4 pg/ml (4.3- 18.3). Analysis was performed using Tobit regression, adjusting for renal and non-renal factors. After adjustment, lower eGFR was associated with higher expected hs-TnT; participants with eGFR <30 ml/min/1.73m2 had 3-fold higher expected hs-TnT compared to subjects with eGFR >60. Older age, male gender, black race, LV mass, diabetes and higher blood pressure all had strong, independent associations with higher expected hs-TnT. Conclusions Knowledge of the determinants of hs-TnT in this cohort may guide further research on the pathology of heart disease in patients with CKD and help to stratify sub-groups of CKD patients at higher cardiovascular risk.
- Subjects
TROPONIN; CHRONIC kidney failure; GLOMERULAR filtration rate; PEOPLE with diabetes; CARDIOVASCULAR diseases; PATIENTS
- Publication
BMC Nephrology, 2013, Vol 14, Issue 1, p1
- ISSN
1471-2369
- Publication type
Article
- DOI
10.1186/1471-2369-14-