Distribution of Cardiac Troponin T in Continuous Hemodialysis Patients and Clinical Characteristics of Patients with Elevated Cardiac Troponin T / 대한신장학회잡지

ABSTRACT

PURPOSE: The leading cause of death of end-stage renal failure is cardiovascular disease. Elevated cardiac troponin T (cTnT) is associated with the high incidence and prevalence of cardiovascular disease and increased mortality and morbidity. Therefore the aim of this study was to examine the distribution of cTnT in continuous hemodialysis patients and clinical significance of elevated cTnT. METHODS: We studied 183 asymptomatic patients who were undergoing chronic continuous hemodialysis treatment. Predialysis blood samples also used to measure hematocrit, albumin, total cholesterol. We evaluated the history of coronary artery disease and the etiologies of renal disease using chart reviews and patients interviews and cardiac status were determined by electrocardiography, two-dimensional echocardiography and coronary angiography. Predialysis cTnT was measured by a second-generation assay, Elecsys 1010 and we considered patients with serum cTnT>0.1 ng/mL as positive. RESULTS: Forty two patients (23%) had cTnT greater than 0.1 ng/mL. Ischemic heart disease was observed in 18.6% (34/183), diabetes mellitus (DM) in 53.6% (98/183), hypertension in 92.3% (169/183) and left ventricular hypertrophy in 67.2% (123/183). cTnT revealed significantly higher level in the patients with age over 60, male, DM, pulse rate over 60 mmHg, ischemic heart disease (IHD), hematocrit under 36% and albumin under 3.7 g/dL. cTnT levels significantly correlated to ischemic heart disease, DM and male. CONCLUSION: In hemodialysis patients, cTnT level is related to age, sex, DM, pulse rate, IHD, hematocrit and albumin. A prospective study is necessary to provide information on the effect of correcting the controllable factors on cTnT level and cardiovascular mortality in maintenance hemodialysis patients.