Author/Editor     Hojs, Radovan; Ekart, Robert; Hojs-Fabjan, Tanja; Pečovnik-Balon, Breda; Gorenjak, Maksimiljan
Title     Cardiac troponin T (cTnT) in hemodialysis patients with asymptomatic and symptomatic atherosclerosis
Type     članek
Source     Arch Med Res
Vol. and No.     Letnik 36
Publication year     2005
Volume     str. 367-71
Language     eng
Abstract     Background. Cardiovascular mortality is higher in hemodialysis (HD) patients than in the general population. Cardiac troponin T (cTnT) is established as a sensitive marker of myocardial injury in the general population. Less is known about the association between cTnT and intima-media thickness (IMT) and presence of plaques in carotid arteries (asymptomatic atherosclerosis) and prognostic value of cTnT for cardiovascular mortality (symptomatic stherosclerosis) in HD patients. Methods. In our study 90 HD patients (mean age 56.2 +/- 13.3 years) were followed after determination of cTnT level. Outcome after 21 months was chosen as the end point. In 52 randomly selected HD patients, IMT was measured with B-mode ultrasonography. Plaque occurrence and their numbers were also determined. Results. In 24 (26.6%) patients, cTnT values were > 0.1 [micro]g/L (positive test for myocardial injury). During follow-up, 13 patients died from cardiovascular causes and their cTnT values were significantly higher (0.12 vs. 0.06 [micro]g/L; p <0.001) than in those who survived. Correlation between cardiovascular mortality and cTnT was found (p <0.001). The cut-off level of 0.1 [micro]g/L resulted in survival rates of 92% and 64% (p=0.0006). The IMT values of carotid artery were significantly higher (0.85 vs. 0.70 mm; p <0.011) in patients with elevated cTnT. All patients with elevated cTnT had plaques and the number of plaques was significantly higher in these patients (p <0.0001). Conclusions. cTnT was frequently elevated in our HD patients and was associated with higher cardiovascular mortality and a predictor of cardiovascular outcome. Patients with elevated cTnT showed advanced asymptomatic atherosclerosis in carotid arteries.
Descriptors     ARTERIOSCLEROSIS
MYOCARDIUM
TROPONIN
CAROTID ARTERIES
TUNICA INTIMA
AGE FACTORS
SEX FACTORS
CARDIOVASCULAR DISEASES
KIDNEY FAILURE, CHRONIC
PROGNOSIS
HEMODIALYSIS
TIME FACTORS
TUNICA MEDIA