The effect of low-flux and high-flux dialysis membrane on plasma concentrations of cardiac troponin I

Aim: Cardiac troponin I (cTnI) concentration stability during dialysis have not been fully elucidated. The aim is to evaluate the effect of a single dialysis session on plasma cTnI. Patients & methods: From 122 consecutive anuric adult patients (75 [61.5%] men, age 27–86 years, median 67) on chronic hemodialysis blood samples for cTnI measurement were taken before and after a dialysis. Results: Dialysis had no effect on high-flux membranes (geometric means ratio = 0.99, 0.94–1.05, df 119, t = -0.19, multiplicity adjusted p = 0.847), but cTnI levels were higher after dialysis in patients on low-flux membranes (geometric means ratio = 1.14, 1.02–1.27, df 119, t = 2.59, adjusted p = 0.021). Conclusion: Dialysis session using low-flux membranes might increase the plasma cTnI.

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Influence of Sampling Time and Ultrafiltration Coefficient of the Dialysis Membrane on Cardiac Troponin I and T

Archives of Pathology & Laboratory Medicine ◽

10.5858/2008-132-72-iostau ◽

2008 ◽

Vol 132 (1) ◽

pp. 72-76 ◽

Cited By ~ 3

Author(s):

Giuseppe Lippi ◽

Nicola Tessitore ◽

Martina Montagnana ◽

Gian Luca Salvagno ◽

Antonio Lupo ◽

...

Keyword(s):

Cardiac Troponin ◽

Troponin I ◽

Statistical Significance ◽

Myocardial Damage ◽

Chronic Hemodialysis ◽

Sampling Time ◽

Cardiac Troponin I ◽

High Flux ◽

Coronary Syndrome ◽

Significant Difference

Abstract Context.—The measurement of cardiac troponin I (TnI) and T (TnT) is essential to diagnose, guide therapy, and predict outcomes of the acute coronary syndrome. Increased levels of troponins, especially TnT, are frequently observed in patients on chronic hemodialysis (HD), reflecting ongoing and subclinical myocardial damage. Objective.—Because these markers are increasingly used for stratification of cardiac risk in these patients, their behavior during HD should be acknowledged to optimize their clinical usefulness. Design.—TnI and TnT were measured in 34 patients pre-HD and post-HD by either high- or low-flux membranes. The post-HD concentrations were corrected for hemoconcentration. Results.—Pre-HD levels above the 99th percentile reference limits of the general population of TnI (>0.06 ng/ mL) and TnT (>0.01 ng/mL) were observed in 9% (13% high-flux, 6% low-flux membranes) and 88% (94% high-flux; 83% low-flux membranes) of the patients, respectively. No significant difference was observed in mean pre-HD values between patients dialyzed by low- and high-flux membranes. The overall decrease post-HD of both troponins (−21% and −17% for TnI and TnT, respectively) only reached statistical significance in patients dialyzed by low-flux membranes (−27% and −37% for TnI and TnT, respectively). A significant correlation was observed between absolute variations of TnI and TnT pre-HD to post-HD. Conclusions.—Results of our investigation attest that high-flux membranes clear both troponins more efficiently from circulation than low-flux membranes. Therefore, sampling time and ultrafiltration coefficient of the HD membrane should be regarded as potential sources of variability in the clinical interpretation of troponin measurement in HD patients.

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Elevations of Troponin I after interventional cardiac catheterization

Cardiology in the Young ◽

10.1017/s1047951101000476 ◽

2001 ◽

Vol 11 (4) ◽

pp. 375-378 ◽

Cited By ~ 6

Author(s):

Prince J. Kannankeril ◽

David F. Wax ◽

Elfriede Pahl

Keyword(s):

Cardiac Catheterization ◽

Cardiac Troponin ◽

Baseline Level ◽

Myocardial Injury ◽

Troponin I ◽

Cardiac Troponin I ◽

Specific Marker ◽

Before And After ◽

Baseline Sample

Background: Elevation of cardiac troponin I in the serum is a specific marker for myocardial injury. We measured levels of troponin I in the serum in children before and after cardiac catheterization to determine if this procedure was associated with an increase in levels of troponin. Methods: We enrolled patients under 21 years of age undergoing cardiac catheterization at our institution. A baseline sample of serum was drawn at the start of the procedure. Repeat samples were obtained immediately after, and six hours subsequent to the procedure. All samples were analyzed for cardiac troponin I using the Abbott AxSYM microparticle immunoassay system. Levels were considered normal (0–0.4 ng/ml) or elevated (>0.4ng/ml). Patients were excluded if the baseline level was elevated. Results: Levels of cardiac troponin I were elevated in the serum from 11 of 14 (79%) cases immediately after the procedure (p < 0.0001), and in 12 of 14 (86%) six hours later (p < 0.0001). Only 2 patients had recognized complications potentially causing myocardial injury. Conclusion: Levels of cardiac troponin I increase in the serum in a high proportion of children after cardiac catheterization. These elevations can be observed immediately, and are maintained for at least six hours. Our study suggests that cardiac catheterization, predominantly intervention, is associated with myocardial injury, even in the absence of complications.

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

Journal of Nephrology ◽

10.1007/s40620-019-00610-5 ◽

2019 ◽

Vol 33 (1) ◽

pp. 129-136

Author(s):

Barbara Maresca ◽

Andrea Manzione ◽

Alessandra Moioli ◽

Gerardo Salerno ◽

Patrizia Cardelli ◽

...

Keyword(s):

Cardiac Troponin ◽

Prognostic Value ◽

Troponin I ◽

Hemodialysis Patients ◽

Chronic Hemodialysis ◽

Cardiac Troponin I

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Evaluation of Myocardial Damage After Electroconvulsive Therapy: Analyses of High-Sensitive Cardiac Troponin I and N-Terminal pro-B-type Natriuretic Peptide

Pharmacopsychiatry ◽

10.1055/a-0646-4278 ◽

2018 ◽

Vol 52 (02) ◽

pp. 92-93

Author(s):

Laura Kranaster ◽

Johanna Badstübner ◽

Suna Aksay ◽

Jan Bumb ◽

Rayan Suliman ◽

...

Keyword(s):

Natriuretic Peptide ◽

Electroconvulsive Therapy ◽

Cardiac Troponin ◽

Cardiovascular Events ◽

Troponin I ◽

Myocardial Damage ◽

Cardiac Troponin I ◽

Safe Procedure ◽

Increased Risk ◽

Before And After

AbstractElectroconvulsive therapy (ECT) is a remarkably safe procedure. However, there might exist a subgroup of patients with an increased risk for cardiovascular events. The cardiac-specific enzymes high-sensitive cardiac troponin I (hscTnI) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) were measured before and after ECT in 23 patients. No relevant increase of hscTnI after ECT was found. Mean NT-proBNP levels were higher after ECT and in three patients a new NT-proBNP elevation after ECT was identified. In conclusion, our small study did not find any evidence for myocardial damage due to ECT by measuring hsTnI, but an increase of NT-proBNP, whose clinical relevance could only be speculated, yet.

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Cardiac troponin-I concentrations in dogs with bradyarrhythmias before and after artificial pacing

Journal of Veterinary Cardiology ◽

10.1016/j.jvc.2010.07.002 ◽

2010 ◽

Vol 12 (3) ◽

pp. 183-190 ◽

Cited By ~ 15

Author(s):

Dennis J. Trafny ◽

Mark A. Oyama ◽

Chloe Wormser ◽

Caryn A. Reynolds ◽

Gretchen E. Singletary ◽

...

Keyword(s):

Cardiac Troponin ◽

Troponin I ◽

Cardiac Troponin I ◽

Before And After

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Concentrations of cardiac Troponin I before and after ovariohysterectomy in 46 female dogs with pyometra

Acta Veterinaria Scandinavica ◽

10.1186/1751-0147-50-35 ◽

2008 ◽

Vol 50 (1) ◽

Cited By ~ 26

Author(s):

Lena Pelander ◽

Ragnvi Hagman ◽

Jens Häggström

Keyword(s):

Cardiac Troponin ◽

Troponin I ◽

Cardiac Troponin I ◽

Before And After

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Moderate elevations of high-sensitivity cardiac troponin I and B-type natriuretic peptide in chronic hemodialysis patients are associated with mortality

Clinical Chemistry and Laboratory Medicine (CCLM) ◽

10.1515/cclm-2012-0305 ◽

2013 ◽

Vol 51 (6) ◽

Cited By ~ 2

Author(s):

Daniël A. Geerse ◽

Miranda van Berkel ◽

Steffie Vogels ◽

Jeroen P. Kooman ◽

Constantijn J.A.M. Konings ◽

...

Keyword(s):

Natriuretic Peptide ◽

Cardiac Troponin ◽

Troponin I ◽

Troponin T ◽

Total Mortality ◽

High Sensitivity ◽

Hemodialysis Patients ◽

Chronic Hemodialysis ◽

Cardiac Troponin I ◽

Moderate Elevation

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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