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

Published online

Journal Article

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 m(2) 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.

Full Text

Duke Authors

Cited Authors

  • Dubin, RF; Li, Y; He, J; Jaar, BG; Kallem, R; Lash, JP; Makos, G; Rosas, SE; Soliman, EZ; Townsend, RR; Yang, W; Go, AS; Keane, M; Defilippi, C; Mishra, R; Wolf, M; Shlipak, MG; CRIC Study Investigators,

Published Date

  • October 22, 2013

Published In

Volume / Issue

  • 14 /

Start / End Page

  • 229 -

PubMed ID

  • 24148285

Pubmed Central ID

  • 24148285

Electronic International Standard Serial Number (EISSN)

  • 1471-2369

Digital Object Identifier (DOI)

  • 10.1186/1471-2369-14-229

Language

  • eng

Conference Location

  • England