Relationships between renal function variations and relative changes in cardiac troponin T concentrations based on quantile generalized additive models (qgam)

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Denis Monneret ◽  
Matteo Fasiolo ◽  
Dominique Bonnefont-Rousselot
Keyword(s):  
Renal Function ◽  
Cardiac Troponin ◽  
Myocardial Injury ◽  
Troponin T ◽  
Generalized Additive Models ◽  
Additive Model ◽  
Additive Models ◽  
Cardiac Troponin T ◽  
Diagnosis Rate ◽  
The Relationship

Abstract Objectives The relationship between high-sensitive cardiac troponin T concentration (hs-cTnT) and renal markers levels is known. However, the extent to which their variations are associated remains to be explored. Objective: model the relationship between relative changes in hs-cTnT (Δhs-cTnT) and variations in creatinine (Δcre) or estimated glomerular filtration rate (ΔeGFR), using a quantile generalized additive model (qgam). Methods Concomitant plasma Δhs-cTnT and Δcre from patients aged 18–100 years, selected with a time variation (Δtime) of 3 h–7 days, were collected over a 5.8-year period. Relationships between Δhs-cTnT and covariates Δcre (A) or ΔeGFR (B), including age, Δtime, hour of blood sampling (HSB) and covariates interactions were fitted using qgam. Results On the whole (n=106567), Δhs-cTnT was mainly associated with Δcre, in a positive and nonlinear way (−21, −6, +5, +20, +55% for −50, −20, +20, +50, +100%, respectively), but to a lesser extent with age (min −9%, max +2%), Δtime (min −4%, max +8%), and HSB (min −5%, max +7%). Δhs-cTnT was negatively associated with ΔeGFR (+46, +7, −5, −11, −20% for −50, −20, +20, +50, +100%, respectively). Classifying Δhs-cTnT as consistent or not with myocardial injury based on recommendations, an interpretation of Δhs-cTnT adjusted for model A or B led to statistically significant but small diagnostic discrepancies (<2%), as compared to an interpretation based on Δhs-cTnT only. Conclusions From a laboratory and statistical standpoint, considering renal function variations when interpreting relative changes in cardiac troponin T has a minor impact on the diagnosis rate of myocardial injury.

scholarly journals Estimated Glomerular Filtration Rate is a Predictive Factor for High-Sensitivity Cardiac Troponin T in a Community-Based 4.8-year Prospective Study

2020 ◽  
Author(s):  
Jie Han ◽  
Xiaona Wang ◽  
Ping Ye ◽  
Ruihua Cao ◽  
Wenkai Xiao ◽  
...  
Keyword(s):  
Cardiac Troponin ◽  
Filtration Rate ◽  
Myocardial Injury ◽  
Estimated Glomerular Filtration Rate ◽  
Troponin T ◽  
Cardiac Troponin T ◽  
Community Based ◽  
Highly Sensitive ◽  
The Relationship

Abstract Objectives: Persistent elevation of cardiac troponin T (cTnT), which is considered as a sensitive and specific biomarker of myocardial injury, is frequently observed in patients with renal insufficiency. Meanwhile, estimated glomerular filtration rate (eGFR) is an independent risk factor of cardiovascular diseases. With a highly sensitive assay, the prevalence of detectable highly sensitive cTnT (hs-cTnT) is greatly improved even in general population. The aim of this study was to better understand the relationship between renal function (eGFR) and myocardial injury (hs-cTnT) in a community-based population.Methods: We analyzed the relationship between baseline eGFR and follow-up hs-cTnT, and the change of hs-cTnT in 1354 participants after 4.8 years follow-up.Results: In Pearson’s correlation analysis, baseline eGFR showed a negative relationship with follow-up hs-cTnT (r=-0.439; P < 0.001). In multiple linear regression analysis, baseline eGFR was independently and negatively associated with follow-up hs-cTnT (β=-0.310, P = 0.005). Stepwise logistic regression models revealed that baseline eGFR was significantly associated with the change in hs-cTnT after 4.8 years follow-up. However, the change in eGFR was not associated with the change in hs-cTnT.Conclusions: Baseline eGFR levels were independently and negatively associated with follow-up hs-cTnT. Furthermore, baseline eGFR levels were an independent predictor of the change in hs-cTnT 4.8 years follow-up, indicating a relationship between renal function and myocardial injury in a community-based population.

scholarly journals Relationship Between Myocardial Injury During Index Hospitalization for SARS‐CoV‐2 Infection and Longer‐Term Outcomes

2021 ◽  
Author(s):  
Brittany Weber ◽  
Hasan Siddiqi ◽  
Guohai Zhou ◽  
Jefferson Vieira ◽  
Andy Kim ◽  
...  
Keyword(s):  
Cardiac Troponin ◽  
Myocardial Injury ◽  
Troponin T ◽  
Cardiac Injury ◽  
High Sensitivity ◽  
Cardiac Biomarkers ◽  
Study Cohort ◽  
Cardiac Troponin T ◽  
Index Hospitalization ◽  
The Relationship

Background Myocardial injury in patients with COVID‐19 is associated with increased mortality during index hospitalization; however, the relationship to long‐term sequelae of SARS‐CoV‐2 is unknown. This study assessed the relationship between myocardial injury (high‐sensitivity cardiac troponin T level) during index hospitalization for COVID‐19 and longer‐term outcomes. Methods and Results This is a prospective cohort of patients who were hospitalized at a single center between March and May 2020 with SARS‐CoV‐2. Cardiac biomarkers were systematically collected. Outcomes were adjudicated and stratified on the basis of myocardial injury. The study cohort includes 483 patients who had high‐sensitivity cardiac troponin T data during their index hospitalization. During index hospitalization, 91 (18.8%) died, 70 (14.4%) had thrombotic complications, and 126 (25.6%) had cardiovascular complications. By 12 months, 107 (22.2%) died. During index hospitalization, 301 (62.3%) had cardiac injury (high‐sensitivity cardiac troponin T≧14 ng/L); these patients had 28.6%, 32.2%, and 33.2% mortality during index hospitalization, at 6 months, and at 12 months, respectively, compared with 4.1%, 4.9%, and 4.9% mortality for those with low‐level positive troponin and 0%, 0%, and 0% for those with undetectable troponin. Of 392 (81.2%) patients who survived the index hospitalization, 94 (24%) had at least 1 readmission within 12 months, of whom 61 (65%) had myocardial injury during the index hospitalization. Of 377 (96%) patients who were alive and had follow‐up after the index hospitalization, 211 (56%) patients had a documented, detailed clinical assessment at 6 months. A total of 78 of 211 (37.0%) had ongoing COVID‐19–related symptoms; 34 of 211 (16.1%) had neurocognitive decline, 8 of 211 (3.8%) had increased supplemental oxygen requirements, and 42 of 211 (19.9%) had worsening functional status. Conclusions Myocardial injury during index hospitalization for COVID‐19 was associated with increased mortality and may predict who are more likely to have postacute sequelae of COVID‐19. Among patients who survived their index hospitalization, the incremental mortality through 12 months was low, even among troponin‐positive patients.

P-65 Relationship Between Renal Function and Serum Cardiac Troponin T in Patients with Chronic Heart Failure

2009 ◽  
Vol 4 ◽  
pp. S70
Author(s):  
Chiho Kawahara ◽  
Takayoshi Tsutamoto ◽  
Masayuki Yamaji ◽  
Keizo Nishiyama ◽  
Takashi Yamamoto ◽  
...  
Keyword(s):  
Heart Failure ◽  
Renal Function ◽  
Chronic Heart Failure ◽  
Cardiac Troponin ◽  
Troponin T ◽  
Cardiac Troponin T ◽  
Serum Cardiac Troponin

Influence of Age and Renal Function on High-Sensitivity Cardiac Troponin T Diagnostic Accuracy for the Diagnosis of Acute Myocardial Infarction

2013 ◽  
Vol 111 (12) ◽  
pp. 1701-1707 ◽  
Author(s):  
Camille Chenevier-Gobeaux ◽  
Christophe Meune ◽  
Yonathan Freund ◽  
Karim Wahbi ◽  
Yann-Erick Claessens ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Renal Function ◽  
Diagnostic Accuracy ◽  
Cardiac Troponin ◽  
Troponin T ◽  
High Sensitivity ◽  
Cardiac Troponin T

scholarly journals Myocardial Injury in Critically Ill Children: A Case Control Study

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Basheir Hassan ◽  
Saed Morsy ◽  
Ahmed Siam ◽  
Al Shaymaa Ali ◽  
Mohamed Abdo ◽  
...  
Keyword(s):  
Disease Severity ◽  
Critically Ill ◽  
Cardiac Troponin ◽  
Myocardial Injury ◽  
Case Control Study ◽  
Troponin T ◽  
Critically Ill Children ◽  
Cardiac Troponin T ◽  
Healthy Children ◽  
Control Study

Objectives. The aim of this study was to investigate the occurrence of myocardial injury in critically ill children through assessment of cardiac troponin T levels and whether levels are associated with disease severity and myocardial dysfunction measured by echocardiography. Methods. Over a 6-month period, this case control study included 50 patients admitted to Pediatric Intensive Care Unit of Zagazig University Children’s Hospital. Twenty-five healthy children were included as a control group. Demographic and clinical data including the pediatric index of mortality II score were recorded. Echocardiographic examination was done and level of cardiac troponin T was measured using Elecsys Troponin T STAT Immunoassay. Results. Cardiac troponin T levels were significantly higher in critically ill in comparison to healthy children (median 22 (18–28) pg/mL versus 10 (10-10) pg/mL, P<0.05). Cardiac troponin T levels correlated positively with duration of ventilation as well as with disease severity and correlated negatively with left ventricular fractional shortening. Moreover, cardiac troponin T levels were significantly higher in nonsurvivors when compared to survivors (median 34.5 (27.5–41.5) pg/mL versus 20 (18–24) pg/mL, P<0.05). Conclusion. In critically ill children, cardiac troponin T levels were elevated and were associated with duration of ventilation and disease severity.

scholarly journals Prognostic Value of Cardiac Troponin T Is Independent of Inflammation, Residual Renal Function, and Cardiac Hypertrophy and Dysfunction in Peritoneal Dialysis Patients

2007 ◽  
Vol 53 (5) ◽  
pp. 882-889 ◽  
Author(s):  
Angela Yee-Moon Wang ◽  
Christopher Wai-Kei Lam ◽  
Mei Wang ◽  
Iris Hiu-Shuen Chan ◽  
William B Goggins ◽  
...  
Keyword(s):  
Renal Function ◽  
Peritoneal Dialysis ◽  
Cardiac Troponin ◽  
Cardiovascular Events ◽  
Prognostic Value ◽  
Troponin T ◽  
Residual Renal Function ◽  
Cardiovascular Death ◽  
Cardiac Troponin T ◽  
All Cause Mortality

Abstract Background: We investigated whether cardiac troponin T (cTnT) independently predicted outcome and added prognostic value over other clinical risk predictors in chronic peritoneal dialysis (PD) with end-stage renal disease. Methods: Baseline cTnT, echocardiography, indices of dialysis adequacy, and biochemical characteristics were assessed in 238 chronic PD patients who were followed prospectively for 3 years or until death. Results: Using multivariable Cox regression analysis, cTnT remained predictive of all-cause mortality [hazard ratio 4.43, 95% CI 1.87–10.45, P = 0.001], cardiovascular death (4.12, 1.29–13.17, P = 0.017), noncardiovascular death (8.06, 1.86–35.03, P = 0.005), and fatal and nonfatal cardiovascular events (CVEs) (3.59, 1.48–8.70, P = 0.005) independent of background coronary artery disease, inflammation, residual renal function, left ventricular hypertrophy, and systolic dysfunction. cTnT alone had better predictive value than C-reactive protein (CRP) alone for mortality [area under the ROC curve (AUC) 0.774 vs 0.691; P = 0.089] and first CVE (AUC 0.711 vs 0.593; P = 0.009) at 3 years. Survival models including age, sex, and clinical, biochemical, and echocardiographic characteristics yielded AUCs of 0.813 (95% CI, 0.748–0.877), 0.800 (95% CI, 0.726–0.874), and 0.769 (95% CI, 0.708–0.830), respectively, in relation to all-cause mortality, cardiovascular death, and fatal and nonfatal cardiovascular events. After addition of cTnT, AUCs of the above models increased significantly to 0.832 (95% CI, 0.669–0.894; P = 0.0037), 0.810 (95% CI, 0.739–0.883; P = 0.0036), and 0.780 (95% CI, 0.720–0.840; P = 0.0002), respectively; no AUCs increased when CRP was added. Conclusions: cTnT is an independent predictor of long-term mortality, cardiovascular death and events, and noncardiovascular death in PD patients.

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