Serrano-Leal Sara, Ruiz-Peña Luis, Jaimes Fabian, Rodelo-Ceballos Joaquin
Internal Medicine, Universidad de Antioquia, Medellin, COL.
Internal Medicine, Universidad de Antioquia, Medellín, COL.
Cureus. 2025 Jun 16;17(6):e86125. doi: 10.7759/cureus.86125. eCollection 2025 Jun.
Background and objectives In patients with end-stage kidney disease (ESKD) undergoing hemodialysis (HD), high-sensitivity cardiac troponin T (hs-cTnT) is a well-established biomarker for predicting all-cause and cardiovascular mortality. However, the prognostic utility of high-sensitivity cardiac troponin I (hs-cTnI) in this population remains uncertain. This study aimed to evaluate the association between hs-cTnI levels and one-year all-cause mortality in ESKD patients on HD presenting without suspected acute coronary syndrome (ACS). Materials and methods We performed a retrospective cohort study including 236 ESKD patients on HD admitted to a tertiary care hospital. hs-cTnI was measured within 24 hours of admission in the absence of clinical suspicion of ACS. Demographic, clinical, and laboratory data were collected. The primary outcome was all-cause mortality at one year. Multivariate logistic regression was used to assess the independent association between elevated hs-cTnI (above the 99th percentile) and mortality. Results A total of 236 patients were included. Elevated hs-cTnI was found in 133 (56.4%) patients, while 103 (43.6%) had non-elevated levels. One-year mortality was higher in the elevated group (43.6% [58/133]) than in the non-elevated group (27.1% [28/103]). However, after adjustment for potential confounders, elevated hs-cTnI was not independently associated with one-year mortality (adjusted odds ratio [aOR]: 1.73; 95% confidence interval [CI]: 0.97-3.08). Conclusions In ESKD patients on HD without suspected ACS, hs-cTnI measured within 24 hours of admission was not an independent predictor of one-year all-cause mortality. These findings suggest limited prognostic utility of hs-cTnI in this setting and support further investigation into the potential superiority of hs-cTnT in this population.
在接受血液透析（HD）的终末期肾病（ESKD）患者中，高敏心肌肌钙蛋白T（hs-cTnT）是预测全因死亡率和心血管死亡率的公认生物标志物。然而，高敏心肌肌钙蛋白I（hs-cTnI）在该人群中的预后价值仍不确定。本研究旨在评估无疑似急性冠状动脉综合征（ACS）的HD治疗的ESKD患者hs-cTnI水平与一年全因死亡率之间的关联。材料与方法：我们进行了一项回顾性队列研究，纳入了一家三级医院收治的236例接受HD治疗的ESKD患者。在无ACS临床怀疑的情况下，于入院24小时内测定hs-cTnI。收集人口统计学、临床和实验室数据。主要结局为一年全因死亡率。采用多因素逻辑回归评估hs-cTnI升高（高于第99百分位数）与死亡率之间的独立关联。结果：共纳入236例患者。133例（56.4%）患者hs-cTnI升高，103例（43.6%）患者hs-cTnI未升高。升高组的一年死亡率（43.6% [58/133]）高于未升高组（27.1% [28/103]）。然而，在对潜在混杂因素进行校正后，hs-cTnI升高与一年死亡率无独立关联（校正比值比[aOR]：1.73；95%置信区间[CI]：0.97 - 3.08）。结论：在无疑似ACS的HD治疗的ESKD患者中，入院24小时内测定的hs-cTnI并非一年全因死亡率的独立预测因素。这些发现表明hs-cTnI在这种情况下的预后价值有限，并支持进一步研究hs-cTnT在该人群中的潜在优势。
