Comportamiento y valor pronóstico de la troponina I cardiaca en suero en pacientes con enfermedad renal final sometidos a hemodiálisis de largo plazo. Analisis de resultados quinquenales

Carmen Cecilia Almonacid Urrego; Jorge de Jesús Cantillo Turbay; María Jesús Tuñón

doi:10.22490/24629448.415

Vol. 7 No. 11 (2009)

Published

2009-06-15

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Almonacid Urrego, C. C., Cantillo Turbay, J. de J., & Tuñón, M. J. (2009). Behaviour and Prognostic Value of Serum Cardiac Troponin I in Patients with End-Stage Renal Disease Undergoing Long-Term Haemodialysis. A Five-Year Outcome Analysis. NOVA Biomedical Sciences Journal, 7(11), 34-42. https://doi.org/10.22490/24629448.415

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Behaviour and Prognostic Value of Serum Cardiac Troponin I in Patients with End-Stage Renal Disease Undergoing Long-Term Haemodialysis. A Five-Year Outcome Analysis

DOI: https://doi.org/10.22490/24629448.415

Section

Research Article (before OJS)

Carmen Cecilia Almonacid Urrego Colegio Mayor, Cundinamarca University

Jorge de Jesús Cantillo Turbay Clínica San Rafael University Hospital, Bogota, Colombia

María Jesús Tuñón Department of Biomedical Sciences and Institute of Biomedicine, University of Leon, Spain.

Cardiac Troponin I (cTnI) levels are considered an important diagnostic tool in acute coronary events. However, there is controversy over their sensitivity, specificity and prognostic value in haemodialysis (HD) patients. The aim of this study was to explore the behaviour and prognostic value of cardiac troponin I in HD patients. Thirty-four asymptomatic patients undergoing long-term haemodialysis were studied. Samples of blood were collected at the start of the study (pre- and post-dialysis serum), after three years (pre-dialysis serum and plasma, with and without the addition of heterophilic antibody-blocking reagent (HBR) and after five years (pre-dialysis serum).

Quantitative cardiac troponin I was measured with an AxSYM cTnI micro-particle enzyme immuno-assay and qualitative cTnI with a Hexagon Troponin immuno-chromatographic one-step test. It did not prove possible to detect any significant association between pre- and post-dialysis cTnI levels.

Comparison of results for serum and heparin plasma revealed no statistically significant difference between the level of cTnI and the mean values for plasma and serum with and without the addition of HBR. The cTnI concentrations in the samples without added HBR were lower than in those with HBR, but no statistically significant difference between the mean for cTnI and the mean of samples with and without added HBR was observed. During the study, 35.2% of the population died. A positive association was observed between the cTnI values in the patients still living and those patients who died from ischaemic cardiomyopathy (p = 0.039).

The crude risk of death by cardiovascular disease was increased eight-fold (the 95% confidence interval being 1.2 to 51.1) in patients with a cTnI concentration greater than 0.04 ng/mL. Levels of cTnI may reflect occult
myocardial ischemia and identify haemodialysis patients who face a greater risk of death.

cardiac biomarkers, cardiac troponin I, chronic renal failure, haemodialysis mortality, myocardial injury, prognostic value of cardiac troponin I.

Vichairuangthum K, Leowattana W, Ong-Ajyooth L, Pokum S. The between serum concentration of cardiac troponin I in chronic renal failure patients and cardiovascular events. J Med Assoc Thai. 2006;89:714 719.

Bueti J, Krahn J, Karpinski M, Bohm C, Fine A, Rigatto C. Manitoba Renal Research Group. Troponin I testing in dialysis patients presenting to the emergency room: does troponin I predict the 30-day outcome?. Nephron Clin Pract. 2006;103:129-136.

Farkouh M, Robbins M, Zafar U, Shimbo D, Davidson K, Puttappa R. Association between troponin I levels and mortality in stable hemodialysis patients. Am J Med. 2003;114:224-226.

Mácsai E, Széll J, Ladányi E, Treszl A, Vásárhelyi B, Madácsy L. Determining factors of cardiac biomarkers in hemodialysed diabetic and non-diabetic patients. Orv Hetil. 2007;18:483-488.

Tripepi G, Mallamaci F, Zoccali C. Inflammation markers, adhesion molecules and all-cause and cardiovascular mortality in patients with ESRD: searching for the best risk marker by multivariate modeling. J Am Soc Nephrol. 2005;16:S83-88.

Huseyin B, Aylin Y, Haldun M. Cardiac enzymes, renal failure and renal transplantation. Clin Med & Research. 2006;4:79-84.

Eriksson S, Halenius H, Pulkki K, Hellman J, Pettersson K. Negative interference in cardiac troponin I immunoassays by circulating troponin autoantibodies. Clin Chem. 2005;51:839-847.

Khan IA, Wattanasuwan N, Mehta NJ, Tun A, Singh N, Singh HK, Vasavada B, Sacchi T. Prognostic value of serum cardiac troponin I in ambulatory patients with chronic renal failure undergoing longterm hemodialysis. A two-year autcome analysis. J Am Coll Cardiol. 2001;38: 991-998.

Peetz D, Schütt S, Sucké B, Faldum A, Wandel E, Hafner G, Lackner K. Prognostic value of troponin T, troponin I, and CK-MBmass in patients with chronic renal failure. Med Klin. 2003;98: 188-192.

Wayand D, Baum H, Schätzle G, Schärf J, Neumeier D. Cardiac Troponin T and I in end-stage renal failure. Clin Chem. 2000;46:1345-1350.

Deleaval P, Descombes E, Magnin JL, Martin PY, Fellay G. Differences in cardiac troponin I and T levels measured in asymptomatic hemodialysis patients with last generation immunoassays. Nephrol Ther. 2006; 2:75-81.

Kim W, Laterza O, Hock K, Pierson-Perry J, Kaminski D. Performance of a revised cardiac troponin method that minimizes interferences from heterophilic antibodies. Clin Chem. 2002;48: 1028-1034.

Saadeddin S, Habbab M, Siddieg H, Fayomi M, Dafterda R. Reliability of the rapid bedside whole-blood quantitative cardiac troponin T assay in the diagnosis of myocardial injury in patients with acute coronary syndrome. Med Sci Monti. 2004;10:43-46.

Lang K, Schindler S, Forberger C, Stein G, Figulla HR. Cardiac troponins have no prognostic value for acute and chronic cardiac events in asymptomatic patients with end-stage renal failure. Clin Nephrol. 2001;56:44-51.

Boulier A, Jaussent I, Terrier N, Maurice F, Rivory J-P, Chalabi L, Boularan1 AM, Delcourt C, Dupuy AM, Canaud B, Cristol JP. Measurement of circulating troponin Ic enhances the prognostic value of C reactive protein in haemodialysis patients. Nephrol Dial Transplant. 2004;19:2313-2318.

Huseyin B, Aylin Y, Haldun M. Cardiac enzymes, renal failure and renal transplantation. Clin Med & Research. 2006;4:79-84.

Khan N, Hemmelgarn B, Tonelli, M, Thompson C, Levin A. Prognostic value of troponin T and I among asymptomatic patients with end-stage renal disease. A meta-analysis. Circulation. 2005; 112:3088-3096.

Beciani M, Tedesco A, Azzarito M, Violante A. Cardiac troponin in chronic hemodialysis. Comparasion of methods and results after 3 months. Recenti Prog Med. 2001;92:660-662.

Apple F, Murakami M, Pearce L, Herzog C. Predictive value of cardiac troponin I and T for subsequent death in end-stage renal disease. Circulation. 2002;106:2941-2945.

Urso S, Garozzo M, Milone F, Battaglia G. Cardiovascular risk markers in hemodialysis patients. Int J Artif Organs. 2004;27:1083-1090.

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Behaviour and Prognostic Value of Serum Cardiac Troponin I in Patients with End-Stage Renal Disease Undergoing Long-Term Haemodialysis. A Five-Year Outcome Analysis

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