Variability of High-sensitivity Cardiac Troponin T and I in Asymptomatic Patients Receiving Hemodialysis

Overview

Journal Sci Rep

Specialty Science

Date 2021 Aug 31

PMID 34462456

Citations 1

Authors

Wanwarang Wongcharoen

Teetad Chombandit

Arintaya Phrommintikul

Kajohnsak Noppakun

Affiliations

Soon will be listed here.

Abstract

Variation of high-sensitivity cardiac troponin I and T (hs-cTn) during hemodialysis has been observed. Observational studies demonstrated the increased incidence of adverse cardiovascular events after long compared to short interdialytic intervals. Therefore, we aimed to compare variation of hs-cTnI and hs-cTnT before and after hemodialysis and between short and long interdialytic intervals. We enrolled 200 asymptomatic patients receiving regular hemodialysis. The hs-cTnI and hs-cTnT levels were measured before and after hemodialysis on the day after short and long interdialytic intervals. Mean age was 62.3 ± 14.8 years (Male 55.5%). Prevalence of increased hs-cTnI and hs-cTnT was 34.5% and 99.0%, respectively. The median ± interquartile range of hs-cTnT increased significantly after hemodialysis during short and long interdialytic intervals. However, hs-cTnI level did not increase after hemodialysis during short and long intervals. We found that levels of hs-cTnI and T did not differ between short interdialytic and long interdialytic intervals. We demonstrated higher prevalence of elevated hs-cTnT in patients with regular hemodialysis compared to hs-cTnI. The rise of hs-cTnT was observed immediately after hemodialysis but no significant change of hs-cTnI was noted. Accordingly, hs-cTnI may be preferable as a diagnostic marker in patients with suspected acute myocardial infarction than hs-cTnT.

Citing Articles

Prognostic values of high sensitivity cardiac troponin T and I for long-term mortality in hemodialysis patients.

Noppakun K, Ratnachina K, Osataphan N, Phrommintikul A, Wongcharoen W Sci Rep. 2022; 12(1):13929.

PMID: 35977974 PMC: 9386012. DOI: 10.1038/s41598-022-17799-4.

References

Foley R, Gilbertson D, Murray T, Collins A . Long interdialytic interval and mortality among patients receiving hemodialysis. N Engl J Med. 2011; 365(12):1099-107. DOI: 10.1056/NEJMoa1103313. View

Chen M, Gerson H, Eintracht S, Nessim S, MacNamara E . Effect of Hemodialysis on Levels of High-Sensitivity Cardiac Troponin T. Am J Cardiol. 2017; 120(11):2061-2064. DOI: 10.1016/j.amjcard.2017.08.026. View

Makar M, Pun P . Sudden Cardiac Death Among Hemodialysis Patients. Am J Kidney Dis. 2017; 69(5):684-695. PMC: 5457912. DOI: 10.1053/j.ajkd.2016.12.006. View

Rittoo D, Jones A, Lecky B, Neithercut D . Elevation of cardiac troponin T, but not cardiac troponin I, in patients with neuromuscular diseases: implications for the diagnosis of myocardial infarction. J Am Coll Cardiol. 2014; 63(22):2411-20. DOI: 10.1016/j.jacc.2014.03.027. View

Kalaji F, Albitar S . Predictive value of cardiac troponin T and I in hemodialysis patients. Saudi J Kidney Dis Transpl. 2012; 23(5):939-45. DOI: 10.4103/1319-2442.100868. View

Hickman P, McGill D, Potter J, Koerbin G, Apple F, Talaulikar G . Multiple biomarkers including cardiac troponins T and I measured by high-sensitivity assays, as predictors of long-term mortality in patients with chronic renal failure who underwent dialysis. Am J Cardiol. 2015; 115(11):1601-6. DOI: 10.1016/j.amjcard.2015.02.066. View

Canney M, Tang M, Er L, Barbour S, Djurdjev O, Levin A . Glomerular Filtration Rate-Specific Cutoffs Can Refine the Prognostic Value of Circulating Cardiac Biomarkers in Advanced Chronic Kidney Disease. Can J Cardiol. 2019; 35(9):1106-1113. DOI: 10.1016/j.cjca.2019.06.014. View

Ooi D, House A . Cardiac troponin T in hemodialyzed patients. Clin Chem. 1998; 44(7):1410-6. View

Aggarwal R, Lebiedz-Odrobina D, Sinha A, Manadan A, Case J . Serum cardiac troponin T, but not troponin I, is elevated in idiopathic inflammatory myopathies. J Rheumatol. 2009; 36(12):2711-4. DOI: 10.3899/jrheum.090562. View

10.

Thygesen K, Alpert J, Jaffe A, Chaitman B, Bax J, Morrow D . Fourth Universal Definition of Myocardial Infarction (2018). Circulation. 2018; 138(20):e618-e651. DOI: 10.1161/CIR.0000000000000617. View

11.

Wong M, Kalman J, Pedagogos E, Toussaint N, Vohra J, Sparks P . Temporal distribution of arrhythmic events in chronic kidney disease: Highest incidence in the long interdialytic period. Heart Rhythm. 2015; 12(10):2047-55. DOI: 10.1016/j.hrthm.2015.06.033. View

12.

Saran R, Robinson B, Abbott K, Bragg-Gresham J, Chen X, Gipson D . US Renal Data System 2019 Annual Data Report: Epidemiology of Kidney Disease in the United States. Am J Kidney Dis. 2019; 75(1 Suppl 1):A6-A7. DOI: 10.1053/j.ajkd.2019.09.003. View

13.

Mbagaya W, Luvai A, Lopez B . Biological variation of cardiac troponin in stable haemodialysis patients. Ann Clin Biochem. 2015; 52(Pt 5):562-8. DOI: 10.1177/0004563215585877. View

14.

Georgianos P, Sarafidis P, Sinha A, Agarwal R . Adverse effects of conventional thrice-weekly hemodialysis: is it time to avoid 3-day interdialytic intervals?. Am J Nephrol. 2015; 41(4-5):400-8. DOI: 10.1159/000435842. View

15.

Porter G, Norton T, Bennett W . Long term follow up of the utility of troponin T to assess cardiac risk in stable chronic hemodialysis patients. Clin Lab. 2000; 46(9-10):469-76. View

16.

Roffi M, Patrono C, Collet J, Mueller C, Valgimigli M, Andreotti F . 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: Task Force for the Management of Acute Coronary Syndromes in Patients Presenting without Persistent ST-Segment.... Eur Heart J. 2015; 37(3):267-315. DOI: 10.1093/eurheartj/ehv320. View

17.

Cheung A, Sarnak M, Yan G, Berkoben M, Heyka R, Kaufman A . Cardiac diseases in maintenance hemodialysis patients: results of the HEMO Study. Kidney Int. 2004; 65(6):2380-9. DOI: 10.1111/j.1523-1755.2004.00657.x. View

18.

Wolley M, Stewart R, Curry E, Davidson J, White H, Pilmore H . Variation in and prognostic importance of troponin T measured using a high-sensitivity assay in clinically stable haemodialysis patients. Clin Kidney J. 2016; 6(4):402-9. PMC: 4898328. DOI: 10.1093/ckj/sfs122. View

19.

Lee M, Doh F, Kim C, Koo H, Oh H, Park J . Interdialytic weight gain and cardiovascular outcome in incident hemodialysis patients. Am J Nephrol. 2014; 39(5):427-35. DOI: 10.1159/000362743. View

20.

Antlanger M, Hecking M, Haidinger M, Werzowa J, Kovarik J, Paul G . Fluid overload in hemodialysis patients: a cross-sectional study to determine its association with cardiac biomarkers and nutritional status. BMC Nephrol. 2013; 14:266. PMC: 4219439. DOI: 10.1186/1471-2369-14-266. View