Increased cardiac troponin T and endothelin-1 concentrations in dialysis patients may indicate heart disease

Abstract Serum cardiac troponin T (cTnT) concentrations are frequently increased in chronic dialysis patients as measured by the first-generation ELISA immunoassay, as is creatine kinase (CK) MB mass in the absence of acute ischemic heart disease. We designed this study to compare four serum markers of myocardial injury [CK-MB mass, first-generation ELISA cTnT, second-generation Enzymun cTnT, and cardiac troponin I (cTnI)] in dialysis patients without acute ischemic heart disease. We also evaluated skeletal muscle from dialysis patients as a potential source of serum cTnT. No patients in the clinical evaluation group (n = 24) studied by history and by physical examination, electrocardiography, and two-dimensional echocardiography had evidence of ischemic heart disease. Biochemical markers were measured in serial predialysis blood samples with specific monoclonal antibody-based immunoassays. For several patients at least one sample measured above the upper reference limit: CK-MB, 7 of 24 (30%); ELISA cTnT, 17 of 24 (71%); Enzymun cTnT, 3 of 18 (17%); and cTnI, 1 of 24 (4%). In a separate group of dialysis patients (n = 5), expression of cTnT, but not cTnI, was demonstrated by Western blot analysis in 4 of 5 skeletal muscle biopsies. Chronic dialysis patients without acute ischemic heart disease frequently had increased serum CK-MB and cTnT. The specificity of the second-generation cTnT (Enzymun) assay was improved over that of the first-generation (ELISA) assay; cTnI was the most specific of the currently available biochemical markers. cTnT, but not cTnI, was expressed in the skeletal muscle of dialysis patients.

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Elevated cardiac troponin T in peritoneal dialysis patients is associated with CRP and predicts all-cause mortality and cardiac death

Nephrology Dialysis Transplantation ◽

10.1093/ndt/17.12.2178 ◽

2002 ◽

Vol 17 (12) ◽

pp. 2178-2183 ◽

Cited By ~ 18

Author(s):

C. Lowbeer

Keyword(s):

Peritoneal Dialysis ◽

Cardiac Troponin ◽

Cardiac Death ◽

Troponin T ◽

Cardiac Troponin T ◽

Dialysis Patients ◽

All Cause Mortality

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The prognostic value of high sensitivity cardiac troponin T in patients with congenital heart disease

Journal of Cardiology ◽

10.1016/j.jjcc.2017.09.012 ◽

2018 ◽

Vol 71 (4) ◽

pp. 389-393 ◽

Cited By ~ 4

Author(s):

Masayuki Abiko ◽

Kei Inai ◽

Eriko Shimada ◽

Seiji Asagai ◽

Toshio Nakanishi

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Cardiac Troponin ◽

Prognostic Value ◽

Congenital Heart ◽

Troponin T ◽

High Sensitivity ◽

Cardiac Troponin T

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Abstract 3486: Minimally Elevated Cardiac Troponin T Independently Predicts Death in Apparently Healthy Adults: Results from the Rancho Bernardo Study

Circulation ◽

10.1161/circ.116.suppl_16.ii_789-b ◽

2007 ◽

Vol 116 (suppl_16) ◽

Author(s):

Lori B Daniels ◽

Gail A Laughlin ◽

Paul Clopton ◽

Alan S Maisel ◽

Elizabeth Barrett-Connor

Keyword(s):

Heart Disease ◽

Cardiac Troponin ◽

Prognostic Value ◽

Troponin T ◽

Healthy Adults ◽

Community Dwelling ◽

Cardiac Troponin T ◽

Risk Of Death ◽

Increased Risk ◽

Apparently Healthy

Background: Minimally elevated levels of cardiac troponin T (TnT), a marker of cardiac myocyte injury, have been found in small subsets of the general population. The significance of these rare elevations is controversial. The purpose of this study was to determine the prognostic value of detectable TnT levels in a population of community-dwelling older adults. Methods: Prospective community-based study of 375 men and 584 women ages 60 to 97 (mean 77) who had plasma TnT measurements (Elecsys® Troponin T, Roche Diagnostics) at baseline (1997–99) and were followed for mortality through July 2006. Participants were divided into 2 groups based on TnT levels: Undetectable (n = 917) and Detectable (≥ 0.01 ng/ml, n = 39). Results: The 39 (4.1%) participants with detectable TnT levels were older and were more likely to be men (both p < 0.01) than those with undetectable TnT. Most of those with detectable TnT levels did not have known heart disease at baseline (79%, 95% C.I. 64 – 89%). During an average 6.3 year follow-up, 220 deaths occurred; 42% were cardiovascular (CV). In Cox proportional hazards regressions, participants with detectable TnT had increased risk of all-cause death (HR = 4.6, 95% CI 3.0 –7.1, Figure ) and of CV death (HR = 5.6, 95% C.I. 3.0 –10.6). Adjusting for age, sex, lifestyle characteristics, and multiple CV risk factors, as well as exclusion of the 152 participants with known heart disease at baseline, did not materially change the TnT-mortality associations. Conclusions: Apparently healthy adults with detectable TnT, even at levels not currently considered abnormal, are at increased risk of death. The prognostic value of TnT persists for years.

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