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Troponin and CKD

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By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
Helen J Jefferies, Risto Tertti, Saara Wittfooth, James O Burton, Kaj Metsärinne, Kim Pettersson, Christopher W McIntyre
Introduction Repetitive dialysis-induced cardiac injury is associated with elevated troponin levels, inflammation, and longitudinal reduction in cardiac function. Pathogenic autoantibodies to cardiac troponins (cTnAAb) produce inflammatory cardiomyopathy in murine models. This study aimed to explore the possibility that analogous autoimmune processes might occur in hemodialysis (HD) patients, by initially investigating cTnAAb prevalence, and exploring potential links with HD-induced myocardial stunning. Methods In 130 prevalent HD patients from two centers (Derby, UK; Turku, Finland), cTnAAb (immunoassay) and cardiac troponins were quantified...
November 20, 2016: Hemodialysis International
Masaki Iwasaki, Kenji Yamazaki, Nobutaka Ikeda, Yuri Tanaka, Toshihide Hayashi, Shun Kubo, Ai Matsukane, Hiroki Hase, Nobuhiko Joki
We challenged to identify the cutoff value of cTnT in chronic kidney disease (CKD) patients by point of care assessment way. A single center, prospective cross-sectional study was planned and performed. 201 consecutive patients who were visited emergency room for chest symptoms were enrolled in this study. All patients were performed routine practice for differential diagnosis of chest symptom by cardiologist. Simultaneously, semiquantitative measurement of cTnT was performed using same blood sampling on the blind condition to cardiologists for this study...
November 15, 2016: Renal Failure
Christopher R deFilippi, Charles A Herzog
BACKGROUND: Chronic kidney disease (CKD) is common, particularly in those of advanced age. Because patients with CKD frequently have cardiac comorbidities and acute or chronic symptoms that may represent heart failure or an acute myocardial infarction (AMI), testing for concentrations of cardiac troponins and natriuretic peptides is frequent. Interpretation of these biomarkers can be challenging when differentiating acute from chronic processes, potentially resulting in missed opportunities to direct appropriate treatment...
January 2017: Clinical Chemistry
Thomas A Mavrakanas, Allan D Sniderman, Paul E Barré, Ahsan Alam
AIM: This study aims to describe the variability of pre-dialysis troponin values in stable haemodialysis patients and compare the performance of single versus fluctuating or persistently elevated troponins in predicting a composite of mortality and cardiac arrest, myocardial infarction, or stroke. METHODS: 128 stable ambulatory chronic haemodialysis patients were enrolled. Pre-dialysis troponin I was measured for three consecutive months. The patients were followed for one year...
October 8, 2016: Nephrology
Wen-Hsien Lee, Po-Chao Hsu, Chun-Yuan Chu, Szu-Chia Chen, Hung-Hao Lee, Meng-Kuang Lee, Chee-Siong Lee, Hsueh-Wei Yen, Tsung-Hsien Lin, Wen-Chol Voon, Wen-Ter Lai, Sheng-Hsiung Sheu, Ho-Ming Su
The aims of this study were to investigate the correlation between renal and cardiac STIs, including pre-ejection period (PEP), ejection time (ET), and PEP/ET, and to assess the diagnostic values of renal STIs in predicting left ventricular ejection fraction (LVEF) <50%. The cross sectional observation study enrolled 230 participants. The renal STIs, including renal PEP (rPEP), renal ET (rET), and rPEP/rET, were measured from electrocardiographic gated renal Doppler ultrasound and cardiac PEP, ET, and PEP/ET were measured from echocardiography...
2016: Scientific Reports
Girish Ganesha Babu, Matthew Webber, Rui Providencia, Sanjeev Kumar, Aerakondal Gopalamurugan, Dominic P Rogers, Holly Louise Daw, Syed Ahsan, Fakhar Khan, Anthony Chow, Martin Lowe, Edward Rowland, Pier Lambiase, Oliver R Segal
BACKGROUND: Chronic kidney disease (CKD) is a risk factor for arrhythmias in patients with heart failure (HF). However, the effects of CKD on ventricular arrhythmia (VA) burden in patients with cardiac resynchronization therapy and defibrillator (CRT-D) devices in a primary prevention setting are unknown. OBJECTIVE: To determine whether baseline CKD is associated with increased risk of VA in patients implanted with primary prevention CRT-D devices. METHODS AND RESULTS: In this retrospective study, 199 consecutive primary prevention CRT-D recipients (2005-2010) were stratified by estimated glomerular filtration rate (eGFR) levels prior to device implantation with 106 (53...
October 6, 2016: Journal of Cardiovascular Electrophysiology
Anne-Sophie Bargnoux, Nils Kuster, Marion Moréna, Gregory Baptista, Leila Chenine, Stéphanie Badiou, Hélène Leray, Anne-Marie Dupuy, Jean-Paul Cristol
New highly sensitive (hs) assays have challenged the interpretation of cardiac troponins (cTn) as markers of injury while natriuretic peptides remain the markers of choice for myocardial dysfunction. However, variability extracardiac factors such as age, gender and renal function may alter circulating levels. In chronic kidney disease (CKD), the increase in circulating levels of these biomarkers in the absence of cardiac disease underlines the problem of discriminative value for diagnosis as well as the need to redefine the thresholds...
August 1, 2016: Annales de Biologie Clinique
A S Omar, P Sivadasan, S Hanoura, S Sudarsanan, Y Shouman, H Ragab, A K Tuli, R Singh, A Al Khulaifi
No abstract text is available yet for this article.
December 2015: Intensive Care Medicine Experimental
Shahram Taheri, Ali Asghar Pilehvarian, Nafiseh Akbari, Samane Musavi, Afsoon Emami Naeini
OBJECTIVE: Patients on hemodialysis (HD) have a high risk for cardiovascular morbidity and mortality. Cardiac troponins are biomarkers for diagnosing acute myocardial injury or infarction. There is considerable controversy that exists in the frequency and significance of cardiac troponins in predicting cardiac injury and ischemia in HD patients. METHODS: In this cross-sectional study, all HD patients more than 18-year-old, who were at least 3 months under HD, and had no sign and symptom of active cardiovascular disease (CVD), in two HD centers were enrolled...
April 2016: Journal of Research in Pharmacy Practice
Thomas A Mavrakanas, Allan D Sniderman, Paul E Barré, Murray Vasilevsky, Ahsan Alam
BACKGROUND: An elevated troponin level is commonly found in asymptomatic patients on hemodialysis (HD) and is associated with higher risk of mortality and major adverse cardiovascular events. The underlying mechanism for the association between adverse outcomes and elevated troponin levels has not been elucidated. METHODS: Two hundred thirty-six stable chronic HD patients from 2 tertiary care centers were enrolled in this study. We measured pre-dialysis troponin I levels with routine monthly bloods for 3 consecutive months...
2016: American Journal of Nephrology
Muthiah Vaduganathan, Deepak L Bhatt
No abstract text is available yet for this article.
2016: American Journal of Nephrology
Li Sun, Xiao Tan, Xuesen Cao, Jianzhou Zou
Objective To analyze the relationship between serum high-sensitivity cardiac troponin T (hs-cTnT) and cardiovascular disease (CVD) among non-dialysis chronic kidney disease (CKD) patients, and to further explore its value of evaluating and predicting CVD in this population. Methods Five hundred and fifty-seven non-dialysis CKD patients were involved in this cross-sectional study. The relationship between serum hs-cTnT and CVD was analyzed using comparison between groups and regression analysis, and its value on assessing cardiac structure and function was evaluated by ROC curves...
June 2016: Renal Failure
Marion A Hofmann Bowman, James K Liao
No abstract text is available yet for this article.
March 29, 2016: Circulation
Rachel M Kruzan, Charles A Herzog, Aozhou Wu, Yingying Sang, Rulan S Parekh, Kunihiro Matsushita, Seungyoung Hwang, Alan Cheng, Josef Coresh, Neil R Powe, Tariq Shafi
BACKGROUND: Sudden cardiac death (SCD) is the most common etiology of death in hemodialysis patients but not much is known about its risk factors. The goal of our study was to determine the association and risk prediction of SCD by serum N-terminal prohormone of brain natriuretic peptide (NTproBNP) troponin I (cTnI) in hemodialysis patients. METHODS: We measured NTproBNP and cTnI in 503 hemodialysis patients of a national prospective cohort study. We determined their association with SCD using Cox regression, adjusting for demographics, co-morbidities, and clinical factors and risk prediction using C-statistic and Net Reclassification Improvement (NRI)...
February 20, 2016: BMC Nephrology
Miranda van Berkel, Marijke J E Dekker, Hanneke Bogers, Daniel A Geerse, Constantijn J A M Konings, Volkher Scharnhorst
Acute myocardial infarction (AMI) is defined as a dynamic change in cardiac troponin (cTn) with at least one cTn value exceeding the 99 th percentile of a reference population in combination with typical clinical symptoms. In hemodialysis (HD) patients, a broad range of cTn concentrations is found, partially due to patient-specific comorbidities. Therefore, the 99 th percentile cannot be used in HD patients and decision algorithms to diagnose AMI should be based on temporal variations of troponin. In this study, relative and absolute variations of cTn in a large population of asymptomatic hemodialysis patients were established during a period of 15 months...
May 1, 2016: Clinica Chimica Acta; International Journal of Clinical Chemistry
Mehrdad Jafari Fesharaki, Saeed Alipour Parsa, Mohsen Nafar, Maryam Ghaffari-Rahbar, Fatemeh Omidi, Hamidreza Karimi-Sari
INTRODUCTION: Myocardial infarction is a common cause of mortality in patients with chronic kidney disease (CKD). Since troponins I and T levels rise in CKD patients without any myocardial cause, diagnostic value of cardiac troponins is not high in these patients. This study aimed to evaluate the value of troponin I and other cardiac biomarkers to differentiate acute coronary syndrome in CKD patients. MATERIALS AND METHODS: In this cross-sectional study, patients with stage 3 to 5 of CKD with typical chest pain were enrolled...
January 2016: Iranian Journal of Kidney Diseases
Marija M Lum, Megan L Fix, Stephen J Bohan
No abstract text is available yet for this article.
July 2016: Annals of Emergency Medicine
Yuwares Sittichanbuncha, Pungkava Sricharoen, Panvilai Tangkulpanich, Kittisak Sawanyawisuth
BACKGROUND: High-sensitivity troponin T (HS Trop T) plays an important role as a diagnostic marker for acute coronary syndrome. It is also related to cardiovascular outcomes. HS Trop T levels may be varied in individuals with renal dysfunction. This study aimed to find the appropriate HS Trop T cutoff points in chronic kidney disease (CKD) patients who had coronary artery occlusion. PATIENTS AND METHODS: The study was conducted at the Emergency Department, Ramathibodi Hospital, Mahidol University, Thailand...
2015: Therapeutics and Clinical Risk Management
Luca Di Lullo, Vincenzo Barbera, Alberto Santoboni, Antonio Bellasi, Mario Cozzolino, Antonio De Pascalis, Rodolfo Rivera, Alessandro Balducci, Domenico Russo, Claudio Ronco
Coronary thrombosis was recognized since 19th century as clinical entity with bad outcomes; only in 1912 it was reported that acute myocardial infarction had to been distinguished from angina pectoris. First diagnostic test was electrocardiogram, while white blood cells count and erythrocytes sedimentation rate were the only available laboratory tests. Late in the 60s and 70s glutammic oxaloacetic and glutamic pyravate transaminase, lactate dehydrogenase and creatine kinase were added to biomarkers pool to provide a diagnosis of myocardial infarction related to myocardial cells injury...
July 2015: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
Thomas Mueller, Alfons Gegenhuber, Gert Kronabethleitner, Isabella Leitner, Meinhard Haltmayer, Benjamin Dieplinger
OBJECTIVES: Biomarkers are useful for establishing disease severity or prognosis in patients with chronic kidney disease. The aim of our study was to determine the plasma concentrations of novel cardiovascular biomarkers in patients on chronic hemodialysis in the context of published upper reference limits (URL) of these biomarkers; and to compare the plasma concentrations of those same analytes before and after hemodialysis session. DESIGN AND METHODS: Plasma concentrations of N-terminal pro-B-type natriuretic peptide (NT-proBNP), mid-regional pro-A-type natriuretic peptide (MR-proANP), mid-regional pro-adrenomedullin (MR-proADM), C-terminal pro-endothelin-1 (CT-proET-1), C-terminal pro-arginine vasopressin (CT-proAVP, also known as Copeptin) and soluble ST2 (sST2) were measured in 28 patients before and after dialysis session...
November 2015: Clinical Biochemistry
2015-08-04 15:37:43
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