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J Am Heart Assoc. 2019 Nov 5;8(21):e013091. doi: 10.1161/JAHA.119.013091. Epub 2019 Oct 30.

Association Between Renal Function and Troponin T Over Time in Stable Chronic Kidney Disease Patients.

Collaborators (233)

Cupisti A, Sagliocca A, Ferraro A, Musiała A, Mele A, Naticchia A, Còsaro A, Woodman A, Ranghino A, Stucchi A, Jonsson A, Schneider A, Pignataro A, Schrander A, Torp A, McKeever A, Szymczak A, Blom AL, De Blasio A, Pani A, Tsalouichos A, Ullah A, McLaren B, van Dam B, Iwig B, Antonio B, Iorio BRD, Rogland B, Perras B, Alessandra B, Harron C, Wallquist C, Siegert C, Barrett C, Gaillard C, Abaterusso C, Beerenhout C, O'Toole C, Somma C, Marx C, Drechsler C, Summersgill C, Blaser C, D'alessandro C, Emde C, Torino C, Zullo C, Pozzi C, Geddes C, Verburgh C, Janmaat C, Bergamo D, Ciurlino D, Motta D, Glowski D, McGlynn D, Vargas D, Krieter D, Russo D, Fuchs D, Sands D, Hoogeveen E, Irmler E, Dimény E, Favaro E, Platen E, Olczyk E, Hoorn E, Vigotti F, Caskey F, Ansali F, Conte F, Cianciotta F, Giacchino F, Cappellaio F, Pizzarelli F, Sundelin F, Greco G, Roy G, Porto G, Bigatti G, Marinangeli G, Cabiddu G, Hirst G, Fumagalli G, Caloro G, Piccoli G, Capasso G, Gambaro G, Tognarelli G, Bonforte G, Conte G, Toscano G, Rosso GD, Welander G, Augustyniak-Bartosik H, Boots J, Schmidt-Gürtler H, King H, McNally H, Schlee H, Boom H, Naujoks H, Masri-Senghor H, Murtagh H, Rayner H, Miśkowiec-Wiśniewska I, Schlee I, Capizzi I, Cäsar S, Hernandez IB, Baragetti I, Manitius J, Turner J, Eijgenraam JW, Kooman J, Beige J, Pondel J, Wilcox J, Berdeprado J, Röthele J, Wong J, Rotmans J, Banda J, Mazur J, Hahn K, Jędrzejak K, Nowańska K, Blouin K, Neumeier K, Jones K, Anding-Rost K, Gröntoft KC, Oldrizzi L, Haydock L, Vogt L, Wilkinson L, Gesualdo L, Schramm L, Biancone L, Nowak Ł, Raasveld M, Szymczak M, Durlik M, Magnano M, Vervloet M, Ricardi M, Carmody M, Di Bari M, Laudato M, Sirico ML, Stendahl M, Svensson M, Weetman M, van Buren M, Joinson M, Ferraresi M, Dutton M, Postorino M, van Diepen M, Matthews M, Provenzano M, Hopf M, Malaguti M, Wuttke N, Morgan N, Palmieri N, Frischmuth N, Bleakley N, Murrone P, Cockwell P, Leurs P, Roderick P, Voskamp P, Kashioulis P, Ichtiaris P, Blankestijn P, Kirste P, Schulz P, Mason P, Kalra P, Cirillo P, Dattolo P, Acampora P, Sajith R, Nigro R, Boero R, Scarpioni R, Sicoli R, Malandra R, Aign S, van Esch S, Chapman S, Biribauer S, Navjee S, Crosbie S, Brown S, Tickle S, Manan S, Röser S, Savoldi S, Bertoli S, Borrelli S, Boorsma S, Heidenreich S, Melander S, Maxia S, Maffei S, Mangano S, Palm S, Konings C, Mathavakkannan S, Schwedler S, Delrieux S, Renker S, Schättel S, Dorota S, Cicchetti T, Nieszporek T, Stephan T, Schmiedeke T, Weinreich T, Leimbach T, Rappa T, Stövesand T, Bahner U, Jensen U, Palazzo V, De Simone W, Seeger W, Kuan Y, Heleniak Z, Aydin Z.

Author information

1
Department of Medical Informatics Academic Medical Center University of Amsterdam Amsterdam Public Health Research Institute Amsterdam The Netherlands.
2
Department of Medicine Karolinska Institutet Stockholm Sweden.
3
Department of Cardiology Huddinge Karolinska University Hospital Stockholm Sweden.
4
Department of Clinical Science, Intervention and Technology Karolinska Institutet Stockholm Sweden.
5
Division of Nephrology Department of Clinical Sciences, Karolinska Institutet Danderyd Hospital Stockholm Sweden.
6
Department of Nephrology Linköping University Linköping Sweden.
7
Department of Medical and Health Sciences Linköping University Linköping Sweden.
8
Centre of Biomedical Engineering Department of Health Technologies School of Informatics Tallinn University of Technology Tallinn Estonia.
9
Department of Clinical Epidemiology Leiden University Medical Center Leiden The Netherlands.
10
Division of Nephrology University Hospital of Wurzburg Germany.

Abstract

Background People with reduced glomerular filtration rate (GFR) often have elevated cardiac troponin T (cTnT) levels. It remains unclear how cTnT levels develop over time in those with chronic kidney disease (CKD). The aim of this study was to prospectively study the association between cTnT and GFR over time in older advanced-stage CKD patients not on dialysis. Methods and Results The EQUAL (European Quality Study) study is an observational prospective cohort study in stage 4 to 5 CKD patients aged ≥65 years not on dialysis (incident estimated GFR, <20 mL/min/1.73 m²). The EQUAL cohort used for the purpose of this study includes 171 patients followed in Sweden between April 2012 and December 2018. We used linear mixed models, adjusted for important groups of confounders, to investigate the effect of both measured GFR and estimated GFR on high-sensitivity cTnT (hs-cTnT) trajectory over 4 years. Almost all patients had at least 1 hs-cTnT measurement elevated above the 99th percentile of the general reference population (≤14 ng/L). On average, hs-cTnT increased by 16%/year (95% CI, 13-19; P<0.0001). Each 15 mL/min/1.73 m2 lower mean estimated GFR was associated with a 23% (95% CI, 14-31; P<0.0001) higher baseline hs-cTnT and 9% (95% CI, 5-13%; P<0.0001) steeper increase in hs-cTnT. The effect of estimated GFR on hs-cTnT trajectory was somewhat lower than a previous myocardial infarction (15%), but higher than presence of diabetes mellitus (4%) and male sex (5%). Conclusions In CKD patients, hs-cTnT increases over time as renal function decreases. Lower CKD stage (each 15 mL/min/1.73 m2 lower) is independently associated with a steeper hs-cTnT increase over time in the same range as other established cardiovascular risk factors.

KEYWORDS:

cardiorenal syndrome; renal disease; renal function; troponin T

PMID:
31662068
DOI:
10.1161/JAHA.119.013091
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