Evaluation of Troponin I Serum Level in Patients With Peritoneal Dialysis and Relationship Between Troponin I and Cardiovascular Risk Factors
Abstract
End-stage renal disease is a situation that predisposes the patients to cardiovascular disease, especially myocardial infarction (MI). A valuable biomarker for the diagnosis of this event is cardiac troponin. Although some asymptomatic patients show high plasma levels of cardiac troponin I, it is still the most sensitive variable in MI. All patients more than 18-year-old, on chronic ambulatory peritoneal dialysis (CAPD) for at least three months, and did not have a history of acute myocardial infarction or hospitalization for CVD during last month are included in a cross-sectional descriptive study. Troponin I serum level was measured by VIDAS Troponin I Ultra (TNIU) Assay. Correlation between serum troponin level and cardiovascular risk factors are evaluated. In this study, 52% of patients were male. The mean cTnI level was 0.025±0.044 ng/mL, less than 0.11 ng/mL, and only five patients had cTnI level more than the laboratory threshold. The cut-off level of cTnI for diagnosing cardiovascular disease must be re-evaluated and maybe increase to 0.3 ng/mL. Indeed, the asymptomatic patient may need more close observation for cardiovascular disease.
1- Stack AG, Bloemberger WE. Prevalence and clinicalcorrelates of coronary artery disease among new dialysispatients in the United States: a cross-sectionalstudy. J Am SocNephrol 2001;12:1516–23.
2- Vonesh EF, Snyder JJ, Foley RN, Collins AJ. Mortality studies comparing peritoneal dialysis and hemodialysis: what do they tell us? Kidney IntSuppl2006;(103):S3–11.
3- Van Biesen W, Vanholder R, Verbeke F, Lameire N. Is peritoneal dialysis associated with increased cardio¬vascular morbidity and mortality? Perit Dial Int2006; 26:429–34.
4- Selby NM, Burton JO, Chesterton LJ, McIntyre CW. Dialysis-induced regional left ventricular dysfunction is ameliorated by cooling the dialysate. Clin J Am SocNephrol2006; 1:1216–25.
5- Selby NM, Christopher W. McIntyre CW. Peritoneal Dialysis Is Not Associatedwith Myocardial Stunning. ? Perit Dial Int2011; 31:27–33.
6- Taskapan MC, Ulutas O, Aksoy Y, Senel S, Sahin I, KosarF, et al. Brain natriuretic peptide and its relationship to left ventricular hypertrophy in patients on peritoneal dialysis or hemodialysis less than 3 years. Ren Fail 2006; 28:133–9.
7- Wang AY, LamCW-k, Yu C-M, WangM, Chan IH-S, Lui S-F, Sanderson JE. Troponin T, left ventricular mass, and function are excellent predictors of cardiovascular congestion in peritoneal dialysis. Kidney International ;2006; 70: 444–452.
8- Alpert JS, Thygesen K, Antman E, Bassand JP: Myocardial infarction redefined--a consensus document of The Joint European Society of Cardiology/American College of Cardiology Committee for the redefinition of myocardial infarction. J Am CollCardiol 2000: 36:959-969.
9- Braunwald E, Antman EM, Beasley JW, Califf RM, Cheitlin MD, Hochman JS, Jones RH, et al. ACC/AHA guidelines for the management of patients with unstable angina and non-ST-segment elevation myocardial infarction. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on the Management of Patients With Unstable Angina). J Am CollCardiol 2000: 36:970-1062.
10- Abbas NA, John RI, Webb MC, Kempson ME, Potter AN, Price CP, Vickery S, Lamb EJ: Cardiac troponins and renal function in nondialysis patients with chronic kidney disease. Clin Chem2005: 51:2059-2066.
11- Ishii J, Nomura M, Okuma T, Minagawa T, Naruse H, Mori Y, Ishikawa T, et al. Risk stratification using serum concentrations of cardiac troponin T in patients with end-stage renal disease on chronic maintenance dialysis. ClinChim Acta2001: 312:69-79.
12- Apple FS, Murakami MM, Pearce LA, Herzog CA: Predictive value of cardiac troponin I and T for subsequent death in end-stage renal disease. Circulation 2002:106:2941-2945.
13- McLaurin MD, Apple FS, Voss EM, Herzog CA, Sharkey SW: Cardiac troponin I, cardiac troponin T, and creatine kinase MB in dialysis patients without ischemic heart disease: evidence of cardiac troponin T expression in skeletal muscle. ClinChem 1997:43:976-982.
14- Martin GS, Becker BN, Schulman G: Cardiac troponin-I accurately predicts myocardial injury in renal failure. Nephrol Dial Transplant 1998: 13:1709-1712.
15- Haaf P, Drexler B, Reichlin T, Twerenbold R, Reiter M, Hochholzer J, et al. High-Sensitivity Cardiac Troponin in the Distinction of Acute Myocardial Infarction From Acute Cardiac Noncoronary Artery Disease.Circulation. 2012;126:31-40.
16- http://www.biomerieux-usa.comwww.accessdata.fda.gov/cdrhdocs/pdf3/K030950.pdf.
17- Apple FS, Smith SW, Pearce LA, Ler R, Murakami MM, Benoit MO,et al. Use of the bioMérieux VIDAS troponin I ultra assay for the diagnosis of myocardial infarction and detection of adverse events in patients presenting with symptoms suggestive of acute coronary syndrome. ClinChimActa.2008 ;390(1-2):72-5.
18- Lamb EJ, Webb MC, Abbas NA. The significance of serum troponin T in patients with kidney disease: a review of the literature. Ann ClinBiochem 2004;41:1–9.
19- Iliou MC, Fumeron C, Benoit MO, Tuppin P, Courvoisier CL,Calonge VM, et al. Factors associated with increased serum levels of cardiac troponins T and I in chronic haemodialysis patients: chronic haemodialysis and new cardiac markers evaluation (CHANCE) study. Nephrol Dial Transplant 2001;16:1452–8.
20- Lippi, G, N., Montagnana, M., Salvagno, G. L., Lupo, A., & Guidi, TessitoreG. C. Influence of sampling time and ultrafiltration coefficient of the dialysis membrane on cardiac troponin I and T. Arch Pathol Lab Med. 2008; 132(1), 72-76.
21- Ricchiuti V, Zhang J, Apple FS. Cardiac troponin I and T alterations in hearts with severe left ventricular remodeling. Clin Chem. 1997;43:990–5.
22- Bozbas H, Yildirir A, Muderrisoglu H. Cardiac Enzymes, Renal Failure and Renal Transplantation. Clinical Medicine & Research. 2006; 4(1): 79-84.
23- Goicoechea M, Garca de Vinuesa S, Gomez-Campdera F, GutierrezMJ, Blanco P, et al. Clinical significance of cardiac troponin Tlevels in chronic kidney disease patients: predictive value forcardiovascular risk. Am J Kidney Dis 2004;43:846–53.
24- Abaci A, Ekici E, Oguzhan A, Tokgoz B, Utas C. Cardiac troponins T and I in patients with end-stage renal disease: the relation with left ventricular mass and their prognostic value. ClinCardiol. 2004 Dec;27(12):704-9.
25- Taheri S, Pilehvarian A, Akbari N,Musavi S, Emami Naeini A. Association between troponin I level and cardiovascular risk factors in asymptomatic hemodialysis patients. J Res Pharm Pract. 2016 Apr-Jun; 5(2): 101–105.
26- Christian Lo¨wbeer C, Gutierrez A, Gustafsson S-A, Norrman R, Hulting J, Seeberger A. Elevated cardiac troponin T in peritoneal dialysis patients is associatedwith CRP and predicts all-cause mortality and cardiac death. Nephrol Dial Transplant (2002) 17: 2178–2183.
27- Ninan VT, Hilali N, Ali JH, Nampoory MR, Akanji AQ, Hussain AA, Zubaid M, David T, Johny KV. Baseline cardiac troponin I in patients on maintenance dialysis. Transplant Proc. 2004 ;36(6):1829-30.
28- Apple FS. A new season for cardiac troponin assays: it’s time to keep a scorecard. Clin Chem, 2009; 55: 1303–1306.
29- Reichlin T, Hochholzer W, Bassetti S, Steuer S, Stelzig C, et al. Early diagnosis of myocardial infarction with sensitive cardiac troponin assays. N Engl J Med, 2009; 361: 858–867.
30- Artunc F, Mueller C, Breidthardt T, Twerenbold R, Peter A, Thamer C et al. Sensitive Troponins – Which Suits Better for Hemodialysis Patients? Associated Factors and Prediction of Mortality. PLoS ONE, 2012; 7(10).
31- Ryu DR, Park JT, Chung JH, Song EM, Roh SH, Lee JM et al. A More Appropriate Cardiac Troponin T Level That Can Predict Outcomes in End-Stage Renal Disease Patients with Acute Coronary Syndrome. Yonsei Med J. 2011; 52(4):595-602.
2- Vonesh EF, Snyder JJ, Foley RN, Collins AJ. Mortality studies comparing peritoneal dialysis and hemodialysis: what do they tell us? Kidney IntSuppl2006;(103):S3–11.
3- Van Biesen W, Vanholder R, Verbeke F, Lameire N. Is peritoneal dialysis associated with increased cardio¬vascular morbidity and mortality? Perit Dial Int2006; 26:429–34.
4- Selby NM, Burton JO, Chesterton LJ, McIntyre CW. Dialysis-induced regional left ventricular dysfunction is ameliorated by cooling the dialysate. Clin J Am SocNephrol2006; 1:1216–25.
5- Selby NM, Christopher W. McIntyre CW. Peritoneal Dialysis Is Not Associatedwith Myocardial Stunning. ? Perit Dial Int2011; 31:27–33.
6- Taskapan MC, Ulutas O, Aksoy Y, Senel S, Sahin I, KosarF, et al. Brain natriuretic peptide and its relationship to left ventricular hypertrophy in patients on peritoneal dialysis or hemodialysis less than 3 years. Ren Fail 2006; 28:133–9.
7- Wang AY, LamCW-k, Yu C-M, WangM, Chan IH-S, Lui S-F, Sanderson JE. Troponin T, left ventricular mass, and function are excellent predictors of cardiovascular congestion in peritoneal dialysis. Kidney International ;2006; 70: 444–452.
8- Alpert JS, Thygesen K, Antman E, Bassand JP: Myocardial infarction redefined--a consensus document of The Joint European Society of Cardiology/American College of Cardiology Committee for the redefinition of myocardial infarction. J Am CollCardiol 2000: 36:959-969.
9- Braunwald E, Antman EM, Beasley JW, Califf RM, Cheitlin MD, Hochman JS, Jones RH, et al. ACC/AHA guidelines for the management of patients with unstable angina and non-ST-segment elevation myocardial infarction. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on the Management of Patients With Unstable Angina). J Am CollCardiol 2000: 36:970-1062.
10- Abbas NA, John RI, Webb MC, Kempson ME, Potter AN, Price CP, Vickery S, Lamb EJ: Cardiac troponins and renal function in nondialysis patients with chronic kidney disease. Clin Chem2005: 51:2059-2066.
11- Ishii J, Nomura M, Okuma T, Minagawa T, Naruse H, Mori Y, Ishikawa T, et al. Risk stratification using serum concentrations of cardiac troponin T in patients with end-stage renal disease on chronic maintenance dialysis. ClinChim Acta2001: 312:69-79.
12- Apple FS, Murakami MM, Pearce LA, Herzog CA: Predictive value of cardiac troponin I and T for subsequent death in end-stage renal disease. Circulation 2002:106:2941-2945.
13- McLaurin MD, Apple FS, Voss EM, Herzog CA, Sharkey SW: Cardiac troponin I, cardiac troponin T, and creatine kinase MB in dialysis patients without ischemic heart disease: evidence of cardiac troponin T expression in skeletal muscle. ClinChem 1997:43:976-982.
14- Martin GS, Becker BN, Schulman G: Cardiac troponin-I accurately predicts myocardial injury in renal failure. Nephrol Dial Transplant 1998: 13:1709-1712.
15- Haaf P, Drexler B, Reichlin T, Twerenbold R, Reiter M, Hochholzer J, et al. High-Sensitivity Cardiac Troponin in the Distinction of Acute Myocardial Infarction From Acute Cardiac Noncoronary Artery Disease.Circulation. 2012;126:31-40.
16- http://www.biomerieux-usa.comwww.accessdata.fda.gov/cdrhdocs/pdf3/K030950.pdf.
17- Apple FS, Smith SW, Pearce LA, Ler R, Murakami MM, Benoit MO,et al. Use of the bioMérieux VIDAS troponin I ultra assay for the diagnosis of myocardial infarction and detection of adverse events in patients presenting with symptoms suggestive of acute coronary syndrome. ClinChimActa.2008 ;390(1-2):72-5.
18- Lamb EJ, Webb MC, Abbas NA. The significance of serum troponin T in patients with kidney disease: a review of the literature. Ann ClinBiochem 2004;41:1–9.
19- Iliou MC, Fumeron C, Benoit MO, Tuppin P, Courvoisier CL,Calonge VM, et al. Factors associated with increased serum levels of cardiac troponins T and I in chronic haemodialysis patients: chronic haemodialysis and new cardiac markers evaluation (CHANCE) study. Nephrol Dial Transplant 2001;16:1452–8.
20- Lippi, G, N., Montagnana, M., Salvagno, G. L., Lupo, A., & Guidi, TessitoreG. C. Influence of sampling time and ultrafiltration coefficient of the dialysis membrane on cardiac troponin I and T. Arch Pathol Lab Med. 2008; 132(1), 72-76.
21- Ricchiuti V, Zhang J, Apple FS. Cardiac troponin I and T alterations in hearts with severe left ventricular remodeling. Clin Chem. 1997;43:990–5.
22- Bozbas H, Yildirir A, Muderrisoglu H. Cardiac Enzymes, Renal Failure and Renal Transplantation. Clinical Medicine & Research. 2006; 4(1): 79-84.
23- Goicoechea M, Garca de Vinuesa S, Gomez-Campdera F, GutierrezMJ, Blanco P, et al. Clinical significance of cardiac troponin Tlevels in chronic kidney disease patients: predictive value forcardiovascular risk. Am J Kidney Dis 2004;43:846–53.
24- Abaci A, Ekici E, Oguzhan A, Tokgoz B, Utas C. Cardiac troponins T and I in patients with end-stage renal disease: the relation with left ventricular mass and their prognostic value. ClinCardiol. 2004 Dec;27(12):704-9.
25- Taheri S, Pilehvarian A, Akbari N,Musavi S, Emami Naeini A. Association between troponin I level and cardiovascular risk factors in asymptomatic hemodialysis patients. J Res Pharm Pract. 2016 Apr-Jun; 5(2): 101–105.
26- Christian Lo¨wbeer C, Gutierrez A, Gustafsson S-A, Norrman R, Hulting J, Seeberger A. Elevated cardiac troponin T in peritoneal dialysis patients is associatedwith CRP and predicts all-cause mortality and cardiac death. Nephrol Dial Transplant (2002) 17: 2178–2183.
27- Ninan VT, Hilali N, Ali JH, Nampoory MR, Akanji AQ, Hussain AA, Zubaid M, David T, Johny KV. Baseline cardiac troponin I in patients on maintenance dialysis. Transplant Proc. 2004 ;36(6):1829-30.
28- Apple FS. A new season for cardiac troponin assays: it’s time to keep a scorecard. Clin Chem, 2009; 55: 1303–1306.
29- Reichlin T, Hochholzer W, Bassetti S, Steuer S, Stelzig C, et al. Early diagnosis of myocardial infarction with sensitive cardiac troponin assays. N Engl J Med, 2009; 361: 858–867.
30- Artunc F, Mueller C, Breidthardt T, Twerenbold R, Peter A, Thamer C et al. Sensitive Troponins – Which Suits Better for Hemodialysis Patients? Associated Factors and Prediction of Mortality. PLoS ONE, 2012; 7(10).
31- Ryu DR, Park JT, Chung JH, Song EM, Roh SH, Lee JM et al. A More Appropriate Cardiac Troponin T Level That Can Predict Outcomes in End-Stage Renal Disease Patients with Acute Coronary Syndrome. Yonsei Med J. 2011; 52(4):595-602.
| Files | ||
| Issue | Vol 57, No 10 (2019) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/acta.v57i10.3231 | |
| Keywords | ||
| Cardiac troponin I Peritoneal dialysis Cardiovascular risk factors | ||
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Taheri S, Pilehvarian AA, Emami Naeini A, Kushki F, Moeinzadeh F. Evaluation of Troponin I Serum Level in Patients With Peritoneal Dialysis and Relationship Between Troponin I and Cardiovascular Risk Factors. Acta Med Iran. 2020;57(10):581-585.
