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BMC Nephrology
Published in: BMC Nephrology 1/2013

Open Access 01-12-2013 | Research article

Predictors of high sensitivity cardiac troponin T in chronic kidney disease patients: a cross-sectional study in the chronic renal insufficiency cohort (CRIC)

Authors: Ruth F Dubin, Yongmei Li, Jiang He, Bernard G Jaar, Radhakrishna Kallem, James P Lash, Gail Makos, Sylvia E Rosas, Elsayed Z Soliman, Ray R Townsend, Wei Yang, Alan S Go, Martin Keane, Christopher deFilippi, Rakesh Mishra, Myles Wolf, Michael G Shlipak, The CRIC Study Investigators

Published in: BMC Nephrology | Issue 1/2013

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Abstract

Background

Cardiac troponin T is independently associated with cardiovascular events and mortality in patients with chronic kidney disease (CKD). Serum levels of high sensitivity cardiac troponin T (hs-TnT) reflect subclinical myocardial injury in ambulatory patients. We sought to determine the distribution and predictors of hs-TnT in CKD patients without overt cardiovascular disease (CVD).

Methods

We studied 2464 participants within the multi-ethnic Chronic Renal Insufficiency Cohort (CRIC) who did not have self-reported CVD. We considered renal and non-renal factors as potential determinants of hs-TnT, including demographics, comorbidities, left ventricular (LV) mass, serologic factors, estimated glomerular filtration rate (eGFR) and albumin to creatinine ratio.

Results

Hs-TnT was detectable in 81% of subjects, and the median (IQR) hs-TnT was 9.4 pg/ml (4.3-18.3). Analysis was performed using Tobit regression, adjusting for renal and non-renal factors. After adjustment, lower eGFR was associated with higher expected hs-TnT; participants with eGFR < 30 ml/min/1.73 m2 had 3-fold higher expected hs-TnT compared to subjects with eGFR > 60. Older age, male gender, black race, LV mass, diabetes and higher blood pressure all had strong, independent associations with higher expected hs-TnT.

Conclusions

Knowledge of the determinants of hs-TnT in this cohort may guide further research on the pathology of heart disease in patients with CKD and help to stratify sub-groups of CKD patients at higher cardiovascular risk.
Appendix
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Metadata
Title
Predictors of high sensitivity cardiac troponin T in chronic kidney disease patients: a cross-sectional study in the chronic renal insufficiency cohort (CRIC)
Authors
Ruth F Dubin
Yongmei Li
Jiang He
Bernard G Jaar
Radhakrishna Kallem
James P Lash
Gail Makos
Sylvia E Rosas
Elsayed Z Soliman
Ray R Townsend
Wei Yang
Alan S Go
Martin Keane
Christopher deFilippi
Rakesh Mishra
Myles Wolf
Michael G Shlipak
The CRIC Study Investigators
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Nephrology / Issue 1/2013
Electronic ISSN: 1471-2369
DOI
https://doi.org/10.1186/1471-2369-14-229

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