Hemodialysis and biomarkers of myocardial infarction - a cohort study.
biomarkers
cardiac troponin
hemodialysis
myocardial infarction
renal disease
Journal
Clinical chemistry and laboratory medicine
ISSN: 1437-4331
Titre abrégé: Clin Chem Lab Med
Pays: Germany
ID NLM: 9806306
Informations de publication
Date de publication:
11 Aug 2023
11 Aug 2023
Historique:
received:
18
01
2023
accepted:
24
07
2023
medline:
9
8
2023
pubmed:
9
8
2023
entrez:
9
8
2023
Statut:
aheadofprint
Résumé
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.
Identifiants
pubmed: 37556843
pii: cclm-2023-0071
doi: 10.1515/cclm-2023-0071
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2023 Walter de Gruyter GmbH, Berlin/Boston.
Références
Wanner, C, Amann, K, Shoji, T. The heart and vascular system in dialysis. Lancet 2016;388:276–84. https://doi.org/10.1016/s0140-6736(16)30508-6 .
doi: 10.1016/s0140-6736(16)30508-6
Thygesen, K, Alpert, JS, Jaffe, AS, Chaitman, BR, Bax, JJ, Morrow, DA, et al.. Fourth universal definition of myocardial infarction (2018). Eur Heart J 2018;40:237–69. https://doi.org/10.1093/eurheartj/ehy462 .
doi: 10.1093/eurheartj/ehy462
Árnadóttir, Á, Falk Klein, C, Iversen, K. Head-to-head comparison of cardiac troponin T and troponin I in patients without acute coronary syndrome: a systematic review. Biomarkers 2017;22:701–8. https://doi.org/10.1080/1354750x.2017.1335779 .
doi: 10.1080/1354750x.2017.1335779
Hammarsten, O, Mair, J, Möckel, M, Lindahl, B, Allan, S, Hammarsten, O, et al.. Possible mechanisms behind cardiac troponin elevations. Biomarkers 2018;23:725–34. https://doi.org/10.1080/1354750X.2018.1490969 .
doi: 10.1080/1354750X.2018.1490969
Friden, V, Starnberg, K, Muslimovic, A, Ricksten, SE, Bjurman, C, Forsgard, N, et al.. Clearance of cardiac troponin T with and without kidney function. Clin Biochem 2017;50:468–74. https://doi.org/10.1016/j.clinbiochem.2017.02.007 .
doi: 10.1016/j.clinbiochem.2017.02.007
Breidthardt, T, Burton, JO, Odudu, A, Eldehni, MT, Jefferies, HJ, Mcintyre, CW. Article troponin T for the detection of dialysis-induced myocardial stunning in hemodialysis patients. Clin J Am Soc Nephrol 2012;7:1285–92. https://doi.org/10.2215/cjn.00460112 .
doi: 10.2215/cjn.00460112
Michos, ED, Wilson, LM, Yeh, HC, Berger, Z, Suarez-Cuervo, C, Stacy, SR, et al.. Prognostic value of cardiac troponin in patients with chronic kidney disease without suspected acute coronary syndrome: a systematic review and meta-analysis. Ann Intern Med 2014;161:491–501. https://doi.org/10.7326/m14-0743 .
doi: 10.7326/m14-0743
Peters, CD, Kjaergaard, KD, Christensen, KL, Bibby, BM, Jespersen, B, Jensen, JD. High-sensitivity Troponin T in hemodialysis patients: a randomized placebo-controlled sub-study investigating angiotensin-II-blockade, variation over time and associations with clinical outcome. BMC Nephrol 2020;21:1–15. https://doi.org/10.1186/s12882-020-02103-1 .
doi: 10.1186/s12882-020-02103-1
Collet, JP, Thiele, H, Barbato, E, Bauersachs, J, Dendale, P, Edvardsen, T, et al.. 2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. Eur Heart J 2021;42:1289–367. https://doi.org/10.1093/eurheartj/ehaa575 .
doi: 10.1093/eurheartj/ehaa575
Twerenbold, R, Badertscher, P, Boeddinghaus, J, Nestelberger, T, Wildi, K, Puelacher, C, et al.. 0/1-Hour triage algorithm for myocardial infarction in patients with renal dysfunction. Circulation 2018;137:436–51. https://doi.org/10.1161/circulationaha.117.028901 .
doi: 10.1161/circulationaha.117.028901
Kaier, TE, Twerenbold, R, Puelacher, C, Marjot, J, Imambaccus, N, Boeddinghaus, J, et al.. Direct comparison of cardiac myosin-binding protein C with cardiac troponins for the early diagnosis of acute myocardial infarction. Circulation 2017;136:1495–508. https://doi.org/10.1161/circulationaha.117.028084 .
doi: 10.1161/circulationaha.117.028084
Kaier, TE, Twerenbold, R, Lopez-Ayala, P, Nestelberger, T, Boeddinghaus, J, Alaour, B, et al.. A 0/1 h-algorithm using cardiac myosin-binding protein C for early diagnosis of myocardial infarction. Eur Heart J Acute Cardiovasc Care 2022;11:325–35. https://doi.org/10.1093/ehjacc/zuac007 .
doi: 10.1093/ehjacc/zuac007
Baker, JO, Tyther, R, Liebetrau, C, Clark, J, Howarth, R, Patterson, T, et al.. Cardiac myosin-binding protein C: a potential early biomarker of myocardial injury. Basic Res Cardiol 2015;110:23. https://doi.org/10.1007/s00395-015-0478-5 .
doi: 10.1007/s00395-015-0478-5
Hasselbalch, RB, Kristensen, JH, Nielsen, TL, Plesner, LL, Rydahl, C, Schou, M, et al.. Mid-regional pro-atrial natriuretic peptide levels before and after hemodialysis predict long-term prognosis. Clin Biochem 2021;94:20–6. https://doi.org/10.1016/j.clinbiochem.2021.04.010 .
doi: 10.1016/j.clinbiochem.2021.04.010
Nielsen, TL, Plesner, LL, Warming, PE, Pallisgaard, JL, Dalsgaard, M, Schou, M, et al.. YKL-40 in patients with end-stage renal disease receiving haemodialysis. Biomarkers 2018;23:357–63. https://doi.org/10.1080/1354750x.2018.1428359 .
doi: 10.1080/1354750x.2018.1428359
Plesner, LL, Warming, PE, Nielsen, TL, Dalsgaard, M, Schou, M, Host, U, et al.. Chronic obstructive pulmonary disease in patients with end-stage kidney disease on hemodialysis. Hemodial Int 2016;20:68–77. https://doi.org/10.1111/hdi.12342 .
doi: 10.1111/hdi.12342
Ersboll, M, Raja, AA, Warming, PE, Nielsen, TL, Plesner, LL, Dalsgaard, M, et al.. Changes in left ventricular filling parameters before and after dialysis in patients with end stage renal disease. Int J Cardiovasc Imag 2019;35:1673–81. https://doi.org/10.1007/s10554-019-01619-4 .
doi: 10.1007/s10554-019-01619-4
Axelsson Raja, A, Warming, PE, Nielsen, TL, Plesner, LL, Ersbøll, M, Dalsgaard, M, et al.. Left-sided heart disease and risk of death in patients with end-stage kidney disease receiving haemodialysis: an observational study. BMC Nephrol 2020;21:413. https://doi.org/10.1186/s12882-020-02074-3 .
doi: 10.1186/s12882-020-02074-3
Marjot, J, Liebetrau, C, Goodson, RJ, Kaier, T, Weber, E, Heseltine, P, et al.. The development and application of a high-sensitivity immunoassay for cardiac myosin-binding protein C. Transl Res 2016;170:17–25.e5. https://doi.org/10.1016/j.trsl.2015.11.008 .
doi: 10.1016/j.trsl.2015.11.008
Alaour, B, Omland, T, Torsvik, J, Kaier, TE, Sylte, MS, Strand, H, et al.. Biological variation of cardiac myosin-binding protein C in healthy individuals. Clin Chem Lab Med 2022;60:576–83. https://doi.org/10.1515/cclm-2021-0306 .
doi: 10.1515/cclm-2021-0306
R Core Team . R: a language and environment for statistical computing [Internet] . Vienna, Austria; 2021. Available from: https://www.r-project.org/ .
Wickham, H, Averick, M, Bryan, J, Chang, W, McGowan, L, François, R, et al.. Welcome to the tidyverse. J Open Source Softw 2019;4:1686. https://doi.org/10.21105/joss.01686 .
doi: 10.21105/joss.01686
Garren, ST. jmuOutlier: permutation tests for nonparametric statistics [Internet] ; 2019. p. R package version 2.2. Available from: https://cran.r-project.org/package=jmuOutlier .
Blanche, P, Dartigues, J-F, Jacqmin-Gadda, H. Estimating and comparing time-dependent areas under receiver operating characteristic curves for censored event times with competing risks. Stat Med 2013;32:5381–97.
Jacquet, S, Yin, X, Sicard, P, Clark, J, Kanaganayagam, GS, Mayr, M, et al.. Identification of cardiac myosin-binding protein C as a candidate biomarker of myocardial infarction by proteomics analysis. Mol Cell Proteomics 2009;8:2687–99. https://doi.org/10.1074/mcp.m900176-mcp200 .
doi: 10.1074/mcp.m900176-mcp200
Wu, AHB, Christenson, RH, Greene, DN, Jaffe, AS, Kavsak, PA, Ordonez-Llanos, J, et al.. Clinical laboratory practice recommendations for the use of cardiac troponin in acute coronary syndrome: expert opinion from the academy of the American association for clinical chemistry and the task force on clinical applications of cardiac bio-markers. Clin Chem 2018;64:645–55. https://doi.org/10.1373/clinchem.2017.277186 .
doi: 10.1373/clinchem.2017.277186
Aakre, KM, Saenger, AK, Body, R, Collinson, P, Hammarsten, O, Jaffe, AS, et al.. Analytical considerations in deriving 99th percentile upper reference limits for high-sensitivity cardiac troponin assays: educational recommendations from the IFCC committee on clinical application of cardiac bio-markers. Clin Chem 2022;68:1022–30. https://doi.org/10.1093/clinchem/hvac092 .
doi: 10.1093/clinchem/hvac092
Stacy, SR, Suarez-Cuervo, C, Berger, Z, Wilson, LM, Yeh, HC, Bass, EB, et al.. Role of troponin in patients with chronic kidney disease and suspected acute coronary syndrome: a systematic review. Ann Intern Med 2014;161:502–12. https://doi.org/10.7326/m14-0746 .
doi: 10.7326/m14-0746
Chen, T, Hassan, HC, Qian, P, Vu, M, Makris, A. High-sensitivity troponin T and C-reactive protein have different prognostic values in Hemo- and peritoneal dialysis populations: a cohort study. J Am Heart Assoc 2018;120:2061–4. https://doi.org/10.1161/jaha.117.007876 .
doi: 10.1161/jaha.117.007876
Keller, T, Wanner, C, Krane, V, Kraus, D, Genser, B, Scharnagl, H, et al.. Prognostic value of high-sensitivity versus conventional cardiac troponin T assays among patients with type 2 diabetes mellitus undergoing maintenance hemodialysis. Am J Kidney Dis 2018;71:822–30. https://doi.org/10.1053/j.ajkd.2017.10.016 .
doi: 10.1053/j.ajkd.2017.10.016
Mavrakanas, TA, Sniderman, AD, Barre, PE, Alam, A. Serial versus single troponin measurements for the prediction of cardiovascular events and mortality in stable chronic haemodialysis patients. Nephrology 2018;23:69–74. https://doi.org/10.1111/nep.12945 .
doi: 10.1111/nep.12945
Castini, D, Persampieri, S, Floreani, R, Galassi, A, Biondi, ML, Carugo, S, et al.. Troponin I levels in asymptomatic hemodialysis patients. Blood Purif 2017;44:236–43. https://doi.org/10.1159/000480225 .
doi: 10.1159/000480225
Chen, M, Gerson, H, Eintracht, S, Nessim, SJ, MacNamara, E. Effect of hemodialysis on levels of high-sensitivity cardiac troponin T. Am J Cardiol 2017;120:2061–4. https://doi.org/10.1016/j.amjcard.2017.08.026 .
doi: 10.1016/j.amjcard.2017.08.026
Hayashi, T, Kimura, T, Yasuda, K, Sasaki, K, Obi, Y, Rakugi, H, et al.. Cardiac troponin T elevation at dialysis initiation is associated with all-cause and cardiovascular mortality on dialysis in patients without diabetic nephropathy. Clin Exp Nephrol 2017;21:333–41. https://doi.org/10.1007/s10157-016-1278-4 .
doi: 10.1007/s10157-016-1278-4
Rutherford, E, Mangion, K, McComb, C, Bell, E, Cockburn, S, Talle, M, et al.. Myocardial changes in incident haemodialysis patients over 6-months: an observational cardiac magnetic resonance imaging study. Sci Rep 2017;7:13976. https://doi.org/10.1038/s41598-017-14481-y .
doi: 10.1038/s41598-017-14481-y
Gunsolus, I, Sandoval, Y, Smith, SW, Sexter, A, Schulz, K, Herzog, CA, et al.. Renal dysfunction influences the diagnostic and prognostic performance of high-sensitivity cardiac troponin I. J Am Soc Nephrol 2018;29:636–43. https://doi.org/10.1681/asn.2017030341 .
doi: 10.1681/asn.2017030341
Huang, HL, Zhu, S, Wang, WQ, Nie, X, Shi, YY, He, Y, et al.. Diagnosis of acute myocardial infarction in hemodialysis patients with high-sensitivity cardiac troponin T assay. Arch Pathol Lab Med 2016;140:75–80. https://doi.org/10.5858/arpa.2014-0580-oa .
doi: 10.5858/arpa.2014-0580-oa
Kavsak, PA, Worster, A, Hill, SA, Jaffe, AS. Evaluation of the Siemens ADVIA Centaur high-sensitivity cardiac troponin I assay in serum. Clin Chim Acta 2018;487:216–21. https://doi.org/10.1016/j.cca.2018.10.012 .
doi: 10.1016/j.cca.2018.10.012
Basit, M, Bakshi, N, Hashem, M, Allebban, Z, Lawson, N, Rosman, HS, et al.. The effect of freezing and long-term storage on the stability of cardiac troponin T. Am J Clin Pathol 2007;128:164–7. https://doi.org/10.1309/lr7fc0luglht8x6j .
doi: 10.1309/lr7fc0luglht8x6j