Hemodialysis and biomarkers of myocardial infarction - a cohort study
Research output: Contribution to journal › Journal article › Research › peer-review
Standard
Hemodialysis and biomarkers of myocardial infarction - a cohort study. / Bo Hasselbalch, Rasmus; Alaour, Bashir; Kristensen, Jonas Henrik; Couch, Liam S.; Kaier, Thomas E.; Nielsen, Ture Lange; Plesner, Louis Lind; Strandkjær, Nina; Schou, Morten; Rydahl, Casper; Goetze, Jens P.; Bundgaard, Henning; Marber, Michael; Iversen, Kasper Karmark.
In: Clinical Chemistry and Laboratory Medicine, Vol. 62, No. 2, 2024, p. 361-370.Research output: Contribution to journal › Journal article › Research › peer-review
Harvard
APA
Vancouver
Author
Bibtex
}
RIS
TY - JOUR
T1 - Hemodialysis and biomarkers of myocardial infarction - a cohort study
AU - Bo Hasselbalch, Rasmus
AU - Alaour, Bashir
AU - Kristensen, Jonas Henrik
AU - Couch, Liam S.
AU - Kaier, Thomas E.
AU - Nielsen, Ture Lange
AU - Plesner, Louis Lind
AU - Strandkjær, Nina
AU - Schou, Morten
AU - Rydahl, Casper
AU - Goetze, Jens P.
AU - Bundgaard, Henning
AU - Marber, Michael
AU - Iversen, Kasper Karmark
N1 - Publisher Copyright: © 2024 Walter de Gruyter GmbH. All rights reserved.
PY - 2024
Y1 - 2024
N2 - Objectives: 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. Methods: 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. Results: 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. Conclusions: 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.
AB - Objectives: 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. Methods: 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. Results: 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. Conclusions: 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.
KW - Biomarkers
KW - Cardiac troponin
KW - Hemodialysis
KW - Myocardial infarction
KW - Renal disease
U2 - 10.1515/cclm-2023-0071
DO - 10.1515/cclm-2023-0071
M3 - Journal article
C2 - 37556843
AN - SCOPUS:85168835505
VL - 62
SP - 361
EP - 370
JO - Clinical Chemistry and Laboratory Medicine
JF - Clinical Chemistry and Laboratory Medicine
SN - 1434-6621
IS - 2
ER -
ID: 386372812