Journal Article

Factors associated with increased serum levels of cardiac troponins T and I in chronic haemodialysis patients: Chronic Haemodialysis And New Cardiac Markers Evaluation (CHANCE) study

Marie C. Iliou, Christine Fumeron, Marie O. Benoit, Philippe Tuppin, Claire Le Courvoisier, Victorio Menoyo Calonge, Nicole Moatti, Claude Buisson and Christian Jacquot

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 16, issue 7, pages 1452-1458
Published in print July 2001 | ISSN: 0931-0509
Published online July 2001 | e-ISSN: 1460-2385 | DOI: http://dx.doi.org/10.1093/ndt/16.7.1452
Factors associated with increased serum levels of cardiac troponins T and I in chronic haemodialysis patients: Chronic Haemodialysis And New Cardiac Markers Evaluation (CHANCE) study

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Background. Serum concentrations of the cardiac troponins (cTn) T and I, specific markers of myocardial injury, are frequently elevated in haemodialysis patients. The clinical relevance of this is unclear. The aim of this study was to investigate factors associated with increased serum levels of cTn in haemodialysis patients.

Methods. We included in this cross‐sectional study 258 chronic haemodialysis patients (150 men, age 60±15 years) without acute coronary symptoms. Clinical data, echocardiographic hypertrophy, biochemical status, and haemodialysis regimen were evaluated for each patient. Pre‐dialysis serum cTnT (Elecsys, Roche), cTnI (Stratus and RXL, Dade–Berhing), and CK‐MB (Stratus, Dade–Berhing) concentrations were determined. Logistic regression was the principal method of analysis.

Results. Pre‐dialysis levels of cTnT >0.1 ng/ml (n=48, 18.6% of patients) were associated with age (P<0.001), diabetes (P<0.005), history of ischaemic heart disease (P<0.05), and left ventricular hypertrophy (P<0.05). In multivariate analysis, age odds ratio ((OR) 1.04), diabetes (OR 4.9), and indexed left ventricular mass (OR 1.01) were found to be independently associated with cTnT concentration above the threshold. Only six patients had cTnI‐Stratus levels >0.6 ng/ml. cTnI‐RXL levels >0.3 ng/ml (n=13, 5.0%) were associated with age (P=0.05) and hypercholesterolaemia (P<0.05). Only age (OR 1.06) remained associated in multivariate analysis.

Conclusion. Elevated baseline serum levels of cardiac troponins were associated with cardiovascular risk factors, history of ischaemic heart disease and left ventricular hypertrophy in asymptomatic chronic haemodialysis patients.

Keywords: cardiac markers; haemodialysis; left ventricular hypertrophy; renal disease; risk factors; troponin

Journal Article.  4643 words.  Illustrated.

Subjects: Nephrology

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