Rabi Ofir, Shavit Linda, Loutati Ranel, Taha Louay, Karmi Mohammad, Brin Akiva, Deeb Dana, Levi Nir, Fink Noam, Sabouret Pierre, Manassra Mohammed, Qadan Abed, Amro Motaz, Glikson Michael, Asher Elad
Jesselson Integrated Heart Center, Shaare Zedek Medical Center, Eisenberg R&D Authority and Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem 9112102, Israel.
Nephrology Unit, Shaare Zedek Medical Center, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem 9112102, Israel.
J Clin Med. 2025 Aug 4;14(15):5470. doi: 10.3390/jcm14155470.
: High-sensitivity cardiac troponin (hs-cTn) is useful for detecting acute myocardial infarction, but chronic hemodialysis patients often have elevated baseline levels that exceed the upper reference limit (URL). This study aimed to determine whether hs-cTnI levels in asymptomatic hemodialysis patients exceed the URL established for the general population, evaluate the impact of high-flux hemodialysis on hs-cTnI concentrations, and examine associations between hs-cTnI levels and subsequent hospitalization or mortality. : A prospective, single-center cohort study was conducted at a tertiary care center from August 2023 to July 2024. Blood samples for hs-cTnI were collected from asymptomatic hemodialysis patients aged ≥ 40 years, measured before and after dialysis within one month. Patients were followed for up to 12 months. : Fifty-six patients were enrolled. The mean hs-cTnI levels were 28.4 ng/L pre-dialysis and 27.9 ng/L post-dialysis, with ranges of <6-223 ng/L and <6-187 ng/L, respectively. The mean hs-cTnI delta between pre- and post-dialysis was -0.5 ng/L, with 52% showing a negative delta, 30% no change, and 18% a positive delta. No association was found between baseline hs-cTnI levels and mortality or hospitalization during follow-up. : Most asymptomatic hemodialysis patients had hs-cTnI levels in the "gray zone", thus neither confirming nor excluding acute myocardial infarction. Dialysis did not significantly affect hs-cTnI levels, and elevated baseline hs-cTnI was not linked to increased mortality or hospitalization over 12 months.
高敏心肌肌钙蛋白（hs-cTn）有助于检测急性心肌梗死，但慢性血液透析患者的基线水平通常会升高，超过参考上限（URL）。本研究旨在确定无症状血液透析患者的hs-cTnI水平是否超过为普通人群设定的URL，评估高通量血液透析对hs-cTnI浓度的影响，并研究hs-cTnI水平与随后住院或死亡之间的关联。
：2023年8月至2024年7月在一家三级医疗中心进行了一项前瞻性、单中心队列研究。收集年龄≥40岁的无症状血液透析患者的hs-cTnI血样，在一个月内透析前后进行测量。对患者进行长达12个月的随访。
：共纳入56例患者。透析前hs-cTnI平均水平为28.4 ng/L，透析后为27.9 ng/L，范围分别为<6-223 ng/L和<6-187 ng/L。透析前后hs-cTnI的平均差值为-0.5 ng/L，52%呈负差值，30%无变化，18%呈正差值。随访期间未发现基线hs-cTnI水平与死亡率或住院率之间存在关联。
：大多数无症状血液透析患者的hs-cTnI水平处于“灰色区域”，因此既不能确诊也不能排除急性心肌梗死。透析对hs-cTnI水平无显著影响，基线hs-cTnI升高与12个月内死亡率或住院率增加无关。
