Variability of high-sensitivity cardiac troponin T and I in asymptomatic patients receiving hemodialysis

Wanwarang Wongcharoen,Arintaya Phrommintikul,Kajohnsak Noppakun,Teetad Chombandit

doi:10.1038/s41598-021-96658-0

Wanwarang Wongcharoen, Arintaya Phrommintikul + Show 2 more

Open Access

https://doi.org/10.1038/s41598-021-96658-0

Copy DOI

Journal: Scientific Reports	Publication Date: Aug 30, 2021
Citations: 2	License type: open-access

Affiliation: Chiang Mai University

Abstract

Variation of high-sensitivity cardiac troponin I and T (hs-cTn) during hemodialysis has been observed. Observational studies demonstrated the increased incidence of adverse cardiovascular events after long compared to short interdialytic intervals. Therefore, we aimed to compare variation of hs-cTnI and hs-cTnT before and after hemodialysis and between short and long interdialytic intervals. We enrolled 200 asymptomatic patients receiving regular hemodialysis. The hs-cTnI and hs-cTnT levels were measured before and after hemodialysis on the day after short and long interdialytic intervals. Mean age was 62.3 ± 14.8 years (Male 55.5%). Prevalence of increased hs-cTnI and hs-cTnT was 34.5% and 99.0%, respectively. The median ± interquartile range of hs-cTnT increased significantly after hemodialysis during short and long interdialytic intervals. However, hs-cTnI level did not increase after hemodialysis during short and long intervals. We found that levels of hs-cTnI and T did not differ between short interdialytic and long interdialytic intervals. We demonstrated higher prevalence of elevated hs-cTnT in patients with regular hemodialysis compared to hs-cTnI. The rise of hs-cTnT was observed immediately after hemodialysis but no significant change of hs-cTnI was noted. Accordingly, hs-cTnI may be preferable as a diagnostic marker in patients with suspected acute myocardial infarction than hs-cTnT.

Highlights

The prevalence of end-stage renal disease (ESRD) and incidence of hemodialysis has distinctly increased during the past two decades[1]
Recent studies have shown that majority of patients with ESRD with chronic hemodialysis had baseline high-sensitivity cardiac troponin I and T (hs-cTn) above the 99th percentile U RL6,7
The hs-cTn level is recommended for the diagnosis of acute myocardial infarction but its cutoff level is derived from epidemiological data in general population without ESRD

Summary

Introduction

The prevalence of end-stage renal disease (ESRD) and incidence of hemodialysis has distinctly increased during the past two decades[1]. According to recent guideline recommendation, high-sensitivity cardiac troponin (hs-cTn) is recommended for the diagnosis of acute myocardial infarction[3,4]. It is defined as the rise of hs-cTn more than the 99th percentile of the upper reference limit (URL) or a rise of hs-cTn more than 20% if baseline level is e levated[4]. Recent studies have shown that majority of patients with ESRD with chronic hemodialysis had baseline hs-cTn above the 99th percentile U RL6,7. The variation of hs-cTn level before, during, and after hemodialysis has been o bserved[8,9,10] With this regard, the diagnosis of acute coronary syndrome in patients undergoing regular hemodialysis is challenging. We sought to examine the difference of hs-cTn I and hs-cTn T levels between long and short interdialytic interval

Objectives

Methods

Discussion

Conclusion