Predictors of high sensitivity cardiac troponin T in chronic kidney disease patients

A cross-sectional study in the chronic renal insufficiency cohort (CRIC)

Ruth F. Dubin, Yongmei Li, Jiang He, Bernard Jaar, Radhakrishna Kallem, James P. Lash, Gail Makos, Sylvia E. Rosas, Elsayed Z. Soliman, Ray R. Townsend, Wei Yang, Alan S. Go, Martin Keane, Christopher Defilippi, Rakesh Mishra, Myles Wolf, Michael G. Shlipak

Research output: Contribution to journalArticle

Abstract

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§ssup§2§esup§ 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.

Original languageEnglish (US)
Article number229
JournalBMC Nephrology
Volume14
Issue number1
DOIs
StatePublished - 2013

Fingerprint

Troponin T
Chronic Renal Insufficiency
Cross-Sectional Studies
Glomerular Filtration Rate
Cardiovascular Diseases
Kidney
Comorbidity
Albumins
Heart Diseases
Creatinine
Demography
Pathology
Hypertension
Mortality
Wounds and Injuries
Serum
Research

Keywords

  • Cardiovascular disease
  • Chronic kidney disease
  • Troponin T

ASJC Scopus subject areas

  • Nephrology

Cite this

Predictors of high sensitivity cardiac troponin T in chronic kidney disease patients : A cross-sectional study in the chronic renal insufficiency cohort (CRIC). / Dubin, Ruth F.; Li, Yongmei; He, Jiang; Jaar, Bernard; Kallem, Radhakrishna; Lash, James P.; Makos, Gail; Rosas, Sylvia E.; Soliman, Elsayed Z.; Townsend, Ray R.; Yang, Wei; Go, Alan S.; Keane, Martin; Defilippi, Christopher; Mishra, Rakesh; Wolf, Myles; Shlipak, Michael G.

In: BMC Nephrology, Vol. 14, No. 1, 229, 2013.

Research output: Contribution to journalArticle

Dubin, RF, Li, Y, He, J, Jaar, B, 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 2013, '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, vol. 14, no. 1, 229. https://doi.org/10.1186/1471-2369-14-229
Dubin, Ruth F. ; Li, Yongmei ; He, Jiang ; Jaar, Bernard ; Kallem, Radhakrishna ; Lash, James P. ; Makos, Gail ; Rosas, Sylvia E. ; Soliman, Elsayed Z. ; Townsend, Ray R. ; Yang, Wei ; Go, Alan S. ; Keane, Martin ; Defilippi, Christopher ; Mishra, Rakesh ; Wolf, Myles ; Shlipak, Michael G. / Predictors of high sensitivity cardiac troponin T in chronic kidney disease patients : A cross-sectional study in the chronic renal insufficiency cohort (CRIC). In: BMC Nephrology. 2013 ; Vol. 14, No. 1.
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abstract = "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§ssup§2§esup§ 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.",
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T1 - Predictors of high sensitivity cardiac troponin T in chronic kidney disease patients

T2 - A cross-sectional study in the chronic renal insufficiency cohort (CRIC)

AU - Dubin, Ruth F.

AU - Li, Yongmei

AU - He, Jiang

AU - Jaar, Bernard

AU - Kallem, Radhakrishna

AU - Lash, James P.

AU - Makos, Gail

AU - Rosas, Sylvia E.

AU - Soliman, Elsayed Z.

AU - Townsend, Ray R.

AU - Yang, Wei

AU - Go, Alan S.

AU - Keane, Martin

AU - Defilippi, Christopher

AU - Mishra, Rakesh

AU - Wolf, Myles

AU - Shlipak, Michael G.

PY - 2013

Y1 - 2013

N2 - 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§ssup§2§esup§ 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.

AB - 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§ssup§2§esup§ 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.

KW - Cardiovascular disease

KW - Chronic kidney disease

KW - Troponin T

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