Elevated cardiac troponin T predicts cardiovascular events in asymptomatic continuous ambulatory peritoneal dialysis patients without a history of cardiovascular disease.

摘要

BACKGROUND: Recent studies revealed that elevated cardiac troponin T (cTnT) could predict all-cause mortality and cardiovascular diseases in end-stage renal disease patients. This study aimed to evaluate cTnT as a prognostic value in asymptomatic continuous ambulatory peritoneal dialysis patients. METHODS: This is a prospective observational study with 107 prevalent peritoneal dialysis patients. cTnT, high-sensitive C-reactive protein (hsCRP) and IL-6 were measured at baseline. Based on cTnT level, patients were classified as higher cTnT group (HT, n = 21, cTnT > or =0.1 ng/ml) and lower cTnT group (LT, n = 86, cTnT <0.1 ng/ml), and were followed for 3 years. Primary endpoint was cardiovascular events. RESULTS: The HT group had a significantly higher level of log hsCRP and log IL-6 than the LT group (p < 0.05). Kaplan-Meier survival demonstrated worse cardiovascular event-free survival for the HT group. Multivariate analysis adjusted for age, cTnT, IL-6 and hsCRP level revealed that age (per 1-year increase, HR 1.07, p < 0.05), elevated cTnT (vs. <0.1 ng/ml, HR 5.89, p < 0.05) and hsCRP (vs. <3.0 mg/l, HR 4.15, p < 0.05) were identified as significant determinants of cardiovascular events. CONCLUSION: This study suggests that cTnT may be an aid in risk stratification of continuous ambulatory peritoneal dialysis patients.