Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand.
Pharmacoepidemiology and Statistics Research Center (PESRC), Faculty of Pharmacy, Chiang Mai University, Chiang Mai, 50200, Thailand.
Sci Rep. 2022 Aug 17;12(1):13929. doi: 10.1038/s41598-022-17799-4.
Previous studies using contemporary cardiac troponin (cTn) assays have shown conflicting results in predictability of mortality and major adverse cardiovascular events (MACEs) in hemodialysis patients. We aimed to evaluate the prognostic values of high-sensitivity cTnT (hs-cTnT) and hs-cTnI for long-term mortality and MACEs in asymptomatic chronic hemodialysis patients. 198 asymptomatic patients undergoing regular hemodialysis (age 62.4 ± 14.8 years) were enrolled. Pre-dialysis hs-cTnT and hs-cTnI levels were measured. The study outcomes were long-term all-cause mortality and MACEs. Median values of hs-cTnT and hs-cTnI were 61.1 ng/L (IQR 36.6-102.0) and 18.4 ng/L (IQR 9.5-36.6), respectively. During a median follow-up of 13.5 months, 30 (15.1%) patients developed MACEs, and 20 (10.1%) patients died. The patients in highest quartile of hs-cTnT level (≥ 102 ng/L) had increased risk of long-term mortality (HR 3.34; 95%CI 1.39-8.04, P = 0.005). However, hs-cTnI levels above highest quartile (≥ 36 ng/L) was not significantly associated with increased risk of all-cause mortality. Nevertheless, elevated level of hs-cTnT and hs-cTnI was associated with increased risk of MACEs. We demonstrated that higher level of hs-cTnT, but not hs-cTnI, was associated with increased risk of long-term mortality. Nevertheless, higher level of hs-cTnT and hs-cTnI both were associated with greater risk of long-term MACEs.
先前使用当代心脏肌钙蛋白（cTn）检测的研究在预测血液透析患者的死亡率和主要不良心血管事件（MACEs）方面得出了相互矛盾的结果。我们旨在评估高敏肌钙蛋白 T（hs-cTnT）和高敏肌钙蛋白 I（hs-cTnI）对无症状慢性血液透析患者的长期死亡率和 MACEs 的预测价值。198 名接受常规血液透析的无症状患者（年龄 62.4±14.8 岁）入组。测量了透析前 hs-cTnT 和 hs-cTnI 水平。研究结局为长期全因死亡率和 MACEs。hs-cTnT 和 hs-cTnI 的中位数分别为 61.1ng/L（IQR 36.6-102.0）和 18.4ng/L（IQR 9.5-36.6）。在中位数为 13.5 个月的随访期间，30 名（15.1%）患者发生了 MACEs，20 名（10.1%）患者死亡。hs-cTnT 水平最高四分位数（≥102ng/L）的患者发生长期死亡的风险增加（HR 3.34；95%CI 1.39-8.04，P=0.005）。然而，hs-cTnI 水平超过最高四分位数（≥36ng/L）与全因死亡率增加无显著相关性。然而，hs-cTnT 和 hs-cTnI 的升高水平与 MACEs 的发生风险增加相关。我们表明，较高水平的 hs-cTnT，但不是 hs-cTnI，与长期死亡率增加相关。然而，较高水平的 hs-cTnT 和 hs-cTnI 均与长期 MACEs 风险增加相关。
