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

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Keywords

  • Cardiovascular disease
  • Chronic kidney disease
  • Troponin T

ASJC Scopus subject areas

  • Nephrology

Cite this

Dubin, R. F., Li, Y., He, J., Jaar, B., Kallem, R., Lash, J. P., Makos, G., Rosas, S. E., Soliman, E. Z., Townsend, R. R., Yang, W., Go, A. S., Keane, M., Defilippi, C., Mishra, R., Wolf, M., & Shlipak, M. G. (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, 14(1), [229]. https://doi.org/10.1186/1471-2369-14-229