Predictors of high sensitivity cardiac troponin T in chronic kidney disease patients: a cross-sectional study in the chronic renal insufficiency cohort (CRIC)

BMC Nephrology

Michael G Shlipak^1,10  Myles Wolf⁹  Rakesh Mishra^1,10  Christopher deFilippi³  Martin Keane⁵  Alan S Go⁶  Wei Yang²  Ray R Townsend⁵  Elsayed Z Soliman¹  Sylvia E Rosas⁵  Gail Makos⁷  James P Lash⁴  Radhakrishna Kallem⁵  Bernard G Jaar⁸  Jiang He^1,11  Yongmei Li^1,10  Ruth F Dubin^1,10 

[1]Epidemiological Cardiology Research Center (EPICARE), Department of Epidemiology, and Department of Internal Medicine, Section on Cardiology, Wake Forest School of Medicine, Winston-Salem, NC, USA

[2]University of Pennsylvania Scientific and Data Coordinating Center, Philadelphia, PA, USA

[3]University of Maryland Medical Center, Baltimore, USA

[4]University of Illinois at Chicago, Chicago, IL, USA

[5]Perelman School of Medicine at University of Pennsylvania, Philadelphia, PA, USA

[6]Kaiser Permanente Northern California, Division of Research, Oakland, CA, USA

[7]St. John’s Health System, Detroit, MI, USA

[8]Johns Hopkins University, Baltimore, MD, USA

[9]University of Miami Miller School of Medicine, Miami, USA

[10]San Francisco VA Medical Center, University of California San Francisco, 4150 Clement Street, Box 111A1, San Francisco, CA 94121, USA

[11]Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA

关键词: Cardiovascular disease;    Chronic kidney disease;    Troponin T;   

Others  :  1082810
DOI  :  10.1186/1471-2369-14-229

 received in 2013-07-05, accepted in 2013-10-03,  发布年份 2013

【 摘 要 】

Background

Cardiac troponin T is independently associated with cardiovascular events and mortality in patients with chronic kidney disease (CKD). Serum levels of high sensitivity cardiac troponin T (hs-TnT) reflect subclinical myocardial injury in ambulatory patients. We sought to determine the distribution and predictors of hs-TnT in CKD patients without overt cardiovascular disease (CVD).

Methods

We studied 2464 participants within the multi-ethnic Chronic Renal Insufficiency Cohort (CRIC) who did not have self-reported CVD. We considered renal and non-renal factors as potential determinants of hs-TnT, including demographics, comorbidities, left ventricular (LV) mass, serologic factors, estimated glomerular filtration rate (eGFR) and albumin to creatinine ratio.

Results

Hs-TnT was detectable in 81% of subjects, and the median (IQR) hs-TnT was 9.4 pg/ml (4.3-18.3). Analysis was performed using Tobit regression, adjusting for renal and non-renal factors. After adjustment, lower eGFR was associated with higher expected hs-TnT; participants with eGFR < 30 ml/min/1.73 m² had 3-fold higher expected hs-TnT compared to subjects with eGFR > 60. Older age, male gender, black race, LV mass, diabetes and higher blood pressure all had strong, independent associations with higher expected hs-TnT.

Conclusions

Knowledge of the determinants of hs-TnT in this cohort may guide further research on the pathology of heart disease in patients with CKD and help to stratify sub-groups of CKD patients at higher cardiovascular risk.

【 授权许可】

   
2013 Dubin et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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