Prognostic value of high-sensitive cardiac troponin I in asymptomatic chronic hemodialysis patients

AbstractSeveral biomarkers are associated with mortality in hemodialysis patients. In particular, elevated cardiac troponin T and B-type natriuretic peptide (BNP) are strong predictors of mortality; however, less is known about cardiac troponin I (cTnI). Elevated troponin I is detected in many hemodialysis patients, but the association of moderate elevations with mortality is unclear.The relation between mortality and cTnI, using a high-sensitivity cTnI assay, as well as BNP and C-reactive protein (CRP) was evaluated in 206 chronic hemodialysis patients.Median follow-up was 28 months with a total mortality of 35%. Mortality was significantly associated with elevated cTnI, BNP and CRP. Even patients with only moderate elevation of cTnI (0.01–0.10 μg/L) showed 2.5-fold increased mortality. Interestingly, hazard ratios for mortality for single (random) measurements were comparable to those for mean/median measurements. Subsequently, subgroup analysis based on combined markers was performed. Patients with both cTnI <0.01 μg/L and BNP in the first quartile had 100% survival. Patients with either cTnI <0.01 μg/L or BNP in the lowest quartile had significantly lower mortality (12% and 13%, respectively) than patients with BNP levels in the second quartile or higher and cTnI of 0.01–0.05 μg/L and patients with cTnI ≥0.05 μg/L (mortality 46 and 58%, respectively).A combination of moderate elevation of cTnI and BNP provided additional prognostic value. A single measurement of these biomarkers performed comparably to the mean/median of multiple measurements.

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Cardiac Findings in Asymptomatic Chronic Hemodialysis Patients with Persistently Elevated Cardiac Troponin I Levels

Renal Failure ◽

10.1080/08860220801947355 ◽

2008 ◽

Vol 30 (4) ◽

pp. 357-362 ◽

Cited By ~ 6

Author(s):

Ioannis Katerinis ◽

Quan-Vinh Nguyen ◽

Jean-Luc Magnin ◽

Eric Descombes

Keyword(s):

Cardiac Troponin ◽

Troponin I ◽

Hemodialysis Patients ◽

Chronic Hemodialysis ◽

Cardiac Troponin I

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Postoperative Cardiac Troponin I (cTnI) Level and Its Prognostic Value for Patients Undergoing Mitral Valve Surgery

International Heart Journal ◽

10.1536/ihj.51.166 ◽

2010 ◽

Vol 51 (3) ◽

pp. 166-169 ◽

Cited By ~ 4

Author(s):

Kiyohiro Oshima ◽

Fumio Kunimoto ◽

Toru Takahashi ◽

Jun Mohara ◽

Izumi Takeyoshi ◽

...

Keyword(s):

Mitral Valve ◽

Cardiac Troponin ◽

Prognostic Value ◽

Troponin I ◽

Mitral Valve Surgery ◽

Valve Surgery ◽

Cardiac Troponin I ◽

Ctni Level

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Prognostic Value of Cardiac Troponin I In Infective Endocarditis

European Heart Journal Supplements ◽

10.1093/eurheartj/suab069.011 ◽

2021 ◽

Vol 23 (Supplement_D) ◽

Author(s):

Salma M Thabet ◽

Marwa Meshaal ◽

Yasser Yazied ◽

Yasser Sharaf

Keyword(s):

Heart Failure ◽

Infective Endocarditis ◽

Cardiac Troponin ◽

Prognostic Value ◽

Troponin I ◽

Cardiac Troponin I ◽

P Value ◽

Significant Relation ◽

P Values ◽

Septic Pulmonary Embolism

Abstract Aim The aim of this study is to assess the prognostic value of cardiac troponin I as a predictor of in-hospital morbidity and mortality in patients with infective endocarditis. Methods This study included 48 patients with definite and possible IE according to modified Duke’s criteria for diagnosis of IE. This prospective longitudinal study was conducted on patients admitted to the cardiovascular department of Cairo University hospitals. All patients were subjected to full history taking and clinical examination, all laboratory and radiological investigations which included chest radiography, echocardiogram and other diagnostic procedures as needed for diagnosis and follow-up of IE were done with emphasis on cardiac troponin I level on admission. Results Troponin I was found to be statistically significant predictor for heart failure (NYHA III/IV), septic pulmonary embolism and in-hospital mortality in infective endocarditis patients by univariate and multivariate regression analysis with P values 0.023, 0.037and 0.002 respectively. Tricuspid valve vegetations had showed significant relation to troponin I levels with p value 0.033. Also it was found that SOFA score on first day of admission showed significant relation to troponin I level with P value 0.045 and 0.004 for prediction of hospital stay duration. Shock and intracranial hemorrhage showed borderline significance with P values 0.097, 0.069. On other hand, troponin I as predictor of pulmonary edema, mechanical complications, systemic embolization, acute kidney injury and presence of aortic root abscess had no statistical significance in our studied patients. Conclusions This study showed that there is as significant predictive value of elevated cardiac troponin I with heart failure, septic pulmonary embolism and all cause in-hospital mortality. In addition, it was significant predictor of the length of hospital stay, lymphocytosis and SOFA score. These results are emphasizing that cTn I level may predict higher risk patients who would need early and aggressive control of infection medically alone or combined with surgery in IE patients.

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Prognostic Value of Troponin I with Echocardiography Assessment in Septic Patients

QJM ◽

10.1093/qjmed/hcab086.001 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Sherif Farouk Ibrahim ◽

Ashraf Elsayed Elagmy ◽

Abdelrhman Gamal Abdelsabour

Keyword(s):

Septic Shock ◽

Acute Coronary Syndrome ◽

Intensive Care ◽

Cardiac Troponin ◽

Prognostic Value ◽

Troponin I ◽

Cardiac Troponin I ◽

Coronary Syndrome ◽

Sepsis And Septic Shock

Abstract Background Sepsis is heterogenous with regard to factors such as causal microorganism, patient predisposition, co-morbidity and response to therapy, a key element and unifying feature is the manifestation of cardiovascular dysfunction. Elevated concentrations of cardiac troponin I (cTnI) are frequently observed in patients with severe sepsis and septic shock even in the absence of an acute coronary syndrome (ACS). Objective To evaluate the prognostic value of (cTnI) with echocardiography assessment in septic patients. Patients and Methods This study was conducted at the intensive care units of Ain Shams university hospitals. 20 patients of both sexes with age ranging from 18 to 70 years diagnosed with sepsis admitted to Intensive care unit were included in prospective observational study. Results Baseline cTnI had a significant positive correlation with follow up troponine (p = 0.0016). Baseline EF had a significant negative correlation with follow up troponine (p = 0.036). Using ROC-curve analysis, troponin level at a cutoff point (>1.9) predicted patients with mortality, with good (87%) accuracy, sensitivity= 90% and specificity= 90% (p < 0.01). Conclusion Elevated concentrations of cardiac troponin I (cTnI) are frequently observed in patients with sepsis and septic shock even in the absence of an acute coronary syndrome.

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