Study of High-Sensitivity Troponin-I level in end-stage renal disease patients receiving hemodialysis
Category:
Background:
Generally, physicians use the 99th percentile of high-sensitivity Troponin I (hsTnI) as a cut off point in one of the acute myocardial infarction (AMI) diagnostic criteria whose data were derived from normal population. There is no data in specific population such as patients with end-stage renal disease (ESRD). This study aimed to determine the difference of hsTnI level between ESRD patients receiving hemodialysis and their matched population with good renal function (eGFR>= 60 ml/min). Moreover, we aimed to determine the effect of hemodialysis on hsTnI.
Objective:
Primary objective
To compare the high sensitive troponin-I level in end-stage renal disease patients receiving hemodialysis without acute cardiovascular event with healthy population.
Secondary objective
To determine the effect of hemodialysis on troponin I
Method:
We compared the high-sensitivity Troponin I in 100 ESRD patients receiving regular hemodialysis (Mean age 64.5 + 13.8 years, male 44%) with 107 matched participants with good renal function (Mean age 63.8 + 9.97 years, male 41%). We also measured hsTnI before and after hemodialysis session in 99 ESRD patients to investigate the effect of hemodialysis.
Results:
We found that hsTnI in the ESRD group was higher than in the control group of which the median was 54.3 ng/L, interquartile range (IQR) 20.6-152.7 ng/L vs 18 ng/L, IQR 6.2-66.1 ng/L (p = 0.000). Troponin-I in the pre-HD patients was higher than in post-HD patients of which the median was 54.3 ng/L, IQR 20.6-152.7ng/L vs 27.1 ng/L, IQR 12.3 - 91.4 ng/L (p = 0.015).
Conclusion:
In ESRD patients, hsTnI is significantly higher than hsTnI in their matched population with good renal function and hemodialysis reduced hsTnI level. These findings implied that an assessment of hsTnI in patients with ESRD should be aware of the effect of renal function and hemodialysis which can alter the level of troponin. Observing the change in troponin level is the recommended strategy in real clinical practice.