Hemodialysis and biomarkers of myocardial infarction - a cohort study

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt


End-stage renal disease is associated with a high risk of cardiovascular disease. We compared the concentration and prognostic ability of high sensitivity cardiac troponin T (hs-cTnT) and I (hs-cTnI) and cardiac myosin-binding protein C (cMyC) among stable hemodialysis patients.

Patients were sampled before and after hemodialysis. We measured hs-cTnI, hs-cTnT and cMyC and used Cox regressions to assess the association between quartiles of concentrations and all-cause mortality and a combination of cardiovascular events and all-cause mortality during follow-up.

A total of 307 patients were included, 204 males, mean age 66 years (SD 14). Before dialysis, 299 (99 %) had a hs-cTnT concentration above the 99th percentile, compared to 188 (66 %) for cMyC and 35 (11 %) for hs-cTnI. Hs-cTnT (23 %, p<0.001) and hs-cTnI (15 %, p=0.049) but not cMyC (4 %, p=0.256) decreased during dialysis. Follow-up was a median of 924 days (492–957 days); patients in the 3rd and 4th quartiles of hs-cTnT (3rd:HR 3.0, 95 % CI 1.5–5.8, 4th:5.2, 2.7–9.8) and the 4th quartile of hs-cTnI (HR 3.8, 2.2–6.8) had an increased risk of mortality. Both were associated with an increased risk of the combined endpoint for patients in the 3rd and 4th quartiles. cMyC concentrations were not associated with risk of mortality or cardiovascular event.

Hs-cTnT was above the 99th percentile in almost all patients. This was less frequent for hs-cTnI and cMyC. High cTn levels were associated with a 3-5-fold higher mortality. This association was not present for cMyC. These findings are important for management of hemodialysis patients.
TidsskriftClinical Chemistry and Laboratory Medicine
Udgave nummer2
Sider (fra-til)361-370
Antal sider10
StatusUdgivet - 2024

Bibliografisk note

Funding Information:
The study was performed in accordance with the Helsinki Declaration II and was approved by The Danish National Committee on Research Ethics (H-3-2013-098) and the Danish Data Protection Agency, Copenhagen (HIH2013-027).

Funding Information:
Research funding: This study was funded by grants from Herlev and Gentofte Hospital and Candys foundation (2019-318). The funders played no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Publisher Copyright:
© 2024 Walter de Gruyter GmbH. All rights reserved.

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