The impact of arterial stiffness on troponin T levels in chronic haemodialysis patients

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Background: Troponin T (TnT) is a highly specific biomarker for myocardial infarction (MI). Haemodialysis (HD) patients often have increased arterial stiffness and elevated TnT. Previous studies have linked elevated TnT with worse outcome, even in the absence of MI. The aim of this study was to evaluate whether arterial stiffness affects TnT-levels in stable HD-patients. Methods: Eighty-one HD-patients recruited as part of the SAFIR-study with urine output >300 mL/day, HD-vintage 30% were followed for 12 months with serial measurements of TnT using a high-sensitivity assay and carotid-femoral pulse wave velocity (cfPWV). Results: At baseline, cfPWV was positively correlated with natural log-transformed TnT (logTnT) and by splitting cfPWV into tertiles (see Figure) the geometric baseline TnT-means with 95% confidence intervals (95%-CI) were: cfPWV12.5 m/s (n = 26): 59(44–78) ng/L (P = 0.03 in ANOVA-test for difference between groups). Baseline cfPWV-tertiles remained significantly correlated with logTnT in multivariate analysis (adjusted for haematocrit, EF, NT-proBNP, ultrafiltration volume and Charlson comorbidity index). Higher TnT-levels at baseline were associated with a higher risk of admission and cardiovascular events during follow-up with logTnT odds-ratios (95%-CI): 2.62(1.22–5.64) and 2.25(1.04–4.86). Increase in TnT over time was significantly correlated with increase in LV-mass and NT-proBNP and decrease in LVEF and late intradialytic stroke volume, but it was not significantly associated with increase in cfPWV. Conclusions: Increased arterial stiffness was associated with higher TnT-levels. Rise in TnT over time was significantly correlated with deterioration of cardiac status.
OriginalsprogEngelsk
TidsskriftArtery Research
Vol/bind24
ISSN1876-4401
DOI
StatusUdgivet - 2018

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