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Clin Biochem. 1999 Nov;32(8):647-52.

Increased mortality in hemodialyzed patients with elevated serum troponin T: a one-year outcome study.

Author information

1
Department of Laboratory Medicine, Ottawa Hospital Civic Campus, Ontario, Canada. dsooi@civich.ottawa.on.ca

Abstract

OBJECTIVES:

To determine the significance of elevated serum troponin T (cTnT) occurring in hemodialysis patients in the absence of clinical evidence of acute coronary ischemia.

DESIGN AND METHODS:

Twelve-month follow-up of cohort of 172 hemodialyzed patients with known serum cTnT concentration. The cohort consisted of patients undergoing hemodialysis in a hospital unit over a 5-month period, with one to four measurements of cTnT. The main outcome measure was death. Cause of death was determined by autopsy in six patients.

RESULTS:

Of the 31 deaths, 12 were due to acute coronary disease, 14 were noncoronary, and 5 were undefined. Death rates of patients with cTnT <0.1, 0.1-0.2, and >0.2 microg/L were 9.9% (11/111), 32.4% (12/37), and 33.3% (8/24), respectively. The increase in death rate with cTnT > or =0.1 microg/L was significant (p<0.001) for noncoronary deaths, but not for acute coronary deaths. The risk ratios for noncoronary deaths in the subgroups were: nondiabetics 6.6 (95% CI 1.9-23.6), patients with no coronary artery disease 7.3 (1.6-32.4), patients with no peripheral vascular disease 8.9 (2.0-39.7), and hypertensives 9.0 (1.1-76.5). Significant increase in coronary deaths was seen only in patients without hypertension and those aged > or =50 years. The risk ratios for these groups were 9.3 (1.2-74.3) and 3.3 (1.0-10.6), respectively.

CONCLUSIONS:

Serum cTnT is a potential prognostic marker of mortality in hemodialyzed patient, with increase in death from coronary and noncoronary causes.

PMID:
10638948
DOI:
10.1016/s0009-9120(99)00064-8
[Indexed for MEDLINE]

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