scholarly journals Evaluation of Troponin I Serum Level in Patients With Peritoneal Dialysis and Relationship Between Troponin I and Cardiovascular Risk Factors

Author(s):  
Shahram Taheri ◽  
Ali Asghar Pilehvarian ◽  
Afsoon Emami Naeini ◽  
Fariba Kushki ◽  
Firouzeh Moeinzadeh

End-stage renal disease is a situation that predisposes the patients to cardiovascular disease, especially myocardial infarction (MI). A valuable biomarker for the diagnosis of this event is cardiac troponin. Although some asymptomatic patients show high plasma levels of cardiac troponin I, it is still the most sensitive variable in MI. All patients more than 18-year-old, on chronic ambulatory peritoneal dialysis (CAPD) for at least three months, and did not have a history of acute myocardial infarction or hospitalization for CVD during last month are included in a cross-sectional descriptive study. Troponin I serum level was measured by VIDAS Troponin I Ultra (TNIU) Assay. Correlation between serum troponin level and cardiovascular risk factors are evaluated. In this study, 52% of patients were male. The mean cTnI level was 0.025±0.044 ng/mL, less than 0.11 ng/mL, and only five patients had cTnI level more than the laboratory threshold. The cut-off level of cTnI for diagnosing cardiovascular disease must be re-evaluated and maybe increase to 0.3 ng/mL. Indeed, the asymptomatic patient may need more close observation for cardiovascular disease. © 2019 Tehran University of Medical Sciences. All rights reserved. 

PLoS ONE ◽  
2012 ◽  
Vol 7 (6) ◽  
pp. e38930 ◽  
Author(s):  
William S. Bradham ◽  
Aihua Bian ◽  
Annette Oeser ◽  
Tebeb Gebretsadik ◽  
Ayumi Shintani ◽  
...  

2007 ◽  
Vol 27 (2_suppl) ◽  
pp. 223-227
Author(s):  
Angela Yee-Moon Wang

End-stage renal disease patients are at a heightened risk of developing cardiovascular disease, with contributions from both “traditional” and “nontraditional” cardiovascular risk factors. Some of the nontraditional risk factors, such as extracellular volume overload, inflammation, and hyperphosphatemia, have also been shown to be important predictors of mortality in the dialysis population. This article provides an in-depth review of the evidence that supports the substantial contributions of nontraditional risk factors to adverse cardiovascular outcomes in chronic peritoneal dialysis patients. In addition, it provides evidence to demonstrate how loss of residual renal function may be central to the development of cardiovascular disease in the peritoneal dialysis population.


1998 ◽  
Vol 80 (11) ◽  
pp. 749-756 ◽  
Author(s):  
Marie-Francoise Aillaud ◽  
Philippe Amouyel ◽  
Alun Evans ◽  
Gérald Luc ◽  
Jean Ferrières ◽  
...  

SummaryThe contribution of coagulation factors and fibrinolytic variables to the development of ischaemic arterial disease is still not clearly established. The PRIME study is a prospective cohort study of myocardial infarction in men aged 50-59 years and recruited from three MONICA field centers in France (Lille, Strasbourg and Toulouse) and the center in Northern Ireland (Belfast). Baseline examination included measurement of plasma fibrinogen, factor VII, and PAI-1 activity in over 10,500 participants. We investigated the associations of these haemo-static variables with cardiovascular risk factors, prevalent atherosclerotic disease and geographical area. Fibrinogen level increased with age, smoking, waist-to-hip ratio, LDL-cholesterol, and it decreased with educational level, leisure physical activity, alcohol intake and HDL-cholesterol. Factor VII activity increased with body mass index, waist-to-hip ratio, triglycerides, HDL- and LDL-cholesterol. PAI-1 activity increased with body mass index, waist-to-hip ratio, triglycerides, alcohol intake, smoking, and decreased with leisure physical activity. PAI-1 level was higher in diabetic subjects than in subjects without diabetes. Cardiovascular risk factors explained 8%, 9%, and 26% of the total variance in fibrinogen, factor VII, and PAI-1, respectively. Compared with participants without prevalent cardiovascular disease, those with previous myocardial infarction (n = 280), angina pectoris (n = 230), or peripheral vascular disease (n = 19) had significantly higher levels of fibrinogen, but those with stroke (n = 67) had not. PAI-1 activity showed a similar pattern of association. The odds ratio for cardiovascular disease associated with a rise of a one standard deviation in fibrinogen and PAI-1 was 1.31 (95% confidence interval: 1.20 to 1.42, p <0.001) and 1.38 (95% confidence interval: 1.27 to 1.49, p <0.001), respectively. After adjustment for cardiovascular risk factors, these associations were attenuated but remained highly significant. There was no significant association between factor VII activity and prevalent cardiovascular disease. Fibrinogen level and, to a lesser extent, factor VII and PAI-1 activity were higher in Northern Ireland than France after adjustment for the main cardiovascular risk factors. These geographical variations are consistent with the 2 to 3-fold higher incidence of myocardial infarction in Northern Ireland than France. Our results provide further epidemiological evidence for a possible role of fibrinogen and PAI-1 in the pathogenesis of coronary heart disease.


2018 ◽  
Vol 64 (11) ◽  
pp. 1607-1616 ◽  
Author(s):  
Paul Welsh ◽  
David Preiss ◽  
Anoop S V Shah ◽  
David McAllister ◽  
Andrew Briggs ◽  
...  

Abstract BACKGROUND Few data compare cardiac troponin T (cTnT) and cardiac troponin I (cTnI) in a general population. We sought to evaluate the distribution and association between cTnT, cTnI, and cardiovascular risk factors in a large general population cohort. METHODS High-sensitivity cTnT and cTnI were measured in serum from 19501 individuals in the Generation Scotland Scottish Family Health Study. Associations with cardiovascular risk factors were compared using age- and sex-adjusted regression. Observed age- and sex-stratified 99th centiles were compared with 99th centiles for cTnT (men, 15.5 ng/L; women, 9.0 ng/L) and cTnI (men, 34.2 ng/L; women, 15.6 ng/L) used in clinical practice. RESULTS cTnT and cTnI concentrations were detectable in 53.3% and 74.8% of participants, respectively, and were modestly correlated in unadjusted analyses (R2 = 21.3%) and only weakly correlated after adjusting for age and sex (R2 = 9.5%). Cardiovascular risk factors were associated with both troponins, but in age- and sex-adjusted analyses, cTnI was more strongly associated with age, male sex, body mass index, and systolic blood pressure (P &lt; 0.0001 for all vs cTnT). cTnT was more strongly associated with diabetes (P &lt; 0.0001 vs cTnI). The observed 99th centiles were broadly consistent with recommended 99th centiles in younger men and women. After the age of 60 years, observed 99th centiles increased substantially for cTnT, and beyond 70 years of age, the 99th centiles approximately doubled for both troponins. CONCLUSIONS In the general population, cTnT and cTnI concentrations are weakly correlated and are differentially associated with cardiovascular risk factors. The 99th centiles currently in use are broadly appropriate for men and women up to but not beyond the age of 60 years.


2017 ◽  
Vol 63 (11) ◽  
pp. 1724-1733 ◽  
Author(s):  
Maros Ferencik ◽  
Thomas Mayrhofer ◽  
Michael T Lu ◽  
Pamela K Woodard ◽  
Quynh A Truong ◽  
...  

Abstract BACKGROUND Most patients presenting to the emergency department (ED) with suspected acute coronary syndrome (ACS) undergo noninvasive cardiac testing with a low diagnostic yield. We determined whether a combination of high-sensitivity cardiac troponin I (hs-cTnI) and cardiovascular risk factors might improve selection of patients for cardiac testing. METHODS We included patients from the Rule Out Myocardial Infarction/Ischemia Using Computer Assisted Tomography (ROMICAT) I and II trials who presented to the ED with acute chest pain and were referred for cardiac testing. Based on serial hs-cTnI measurements and cardiovascular risk factors, we derived and validated the criterion for no need of cardiac testing. We predicted the effect of this criterion on the effectiveness of patient management. RESULTS A combination of baseline hs-cTnI (&lt;4 ng/L) and cardiovascular risk factors (&lt;2) ruled out ACS with a negative predictive value of 100% in ROMICAT I. We validated this criterion in ROMICAT II, identifying 29% patients as not needing cardiac testing. An additional 5% of patients were identified by adding no change or a decrease between baseline and 2 h hs-cTnI as a criterion. Assuming those patients would be discharged from the ED without cardiac testing, implementation of hs-cTnI would increase ED discharge rate (24.3% to 50.2%, P &lt; 0.001) and decrease the length of hospital stay (21.4 to 8.2 h, P &lt; 0.001), radiation dose (10.2 to 7.7 mSv, P &lt; 0.001), and costs of care (4066 to 3342 US$, P &lt; 0.001). CONCLUSIONS We derived and validated a criterion for combined hs-cTnI and cardiovascular risk factors that identified acute chest pain patients with no need for cardiac testing and could improve effectiveness of patient management. ClinicalTrials.gov Identifiers: NCT00990262 and NCT01084239


2021 ◽  
pp. 1-13
Author(s):  
Elisabeth Maria van Zutphen ◽  
Judith Johanna Maria Rijnhart ◽  
Didericke Rhebergen ◽  
Majon Muller ◽  
Martijn Huisman ◽  
...  

Background: Sex differences in cognitive functioning in old age are known to exist yet are still poorly understood. Objective: This study examines to what extent differences in cardiovascular risk factors and cardiovascular disease between men and women explain sex differences in cognitive functioning. Methods: Data from 2,724 older adults from the Longitudinal Aging Study Amsterdam were used. Information processing speed and episodic memory, measured three times during six years of follow-up, served as outcomes. The mediating role of cardiovascular risk factors and cardiovascular disease was examined in single and multiple mediator models. Determinant-mediator effects were estimated using linear or logistic regression, and determinant-outcome and mediator-outcome effects were estimated using linear mixed models. Indirect effects were estimated using the product-of-coefficients estimator. Results: Women scored 1.58 points higher on information processing speed and 1.53 points higher on episodic memory. Several cardiovascular risk factors had small mediating effects. The sex difference in information processing speed was mediated by smoking, depressive symptoms, obesity, and systolic blood pressure. The sex difference in episodic memory was mediated by smoking, physical activity, and depressive symptoms. Effects of smoking, LDL cholesterol, and diabetes mellitus on information processing speed differed between men and women. Conclusion: Differences in cardiovascular risk factors between women and men partially explained why women had better cognitive functioning. A healthy cardiovascular lifestyle seems beneficial for cognition and sex-specific strategies may be important to preserve cognitive functioning at older age.


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