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Prognostic value of troponin T and homocysteine in patients with end-stage renal disease.
Turk Kardiyol Dern Ars 2008; 36(6):382-7TK

Abstract

OBJECTIVES

The most important cause of increased mortality in end-stage renal disease (ESRD) is cardiovascular diseases. We investigated the prognostic value of cardiac troponin T (cTnT) and homocysteine in the long-term follow-up of ESRD patients.

STUDY DESIGN

The study included 78 patients (54 males, 24 females; mean age 53.2+/-16.6 years) with ESRD, who had been on hemodialysis treatment for at least three months. Baseline troponin T and homocysteine levels were measured and the patients were followed-up from March 2002 to May 2007 for major adverse cardiovascular events (MACE).

RESULTS

Major adverse cardiovascular events occurred in 26 patients (33.3%), including cerebrovascular events (n=3, 3.9%), congestive heart failure (CHF) (n=18, 23.1%), coronary artery disease (CAD) (n=19, 24.4%), and death (n=19, 24.4%). Two-thirds of diabetic patients developed MACE and the mean age in the MACE group was significantly greater (p<0.001). Troponin T levels were significantly higher in patients who developed MACE (0.21+/-0.43 ng/ml vs 0.06+/-0.28 ng/ml, p=0.002), whereas homocysteine levels did not differ significantly between the two groups (p=0.82). For a cutoff value of 0.10 ng/ml, cTnT was > or =0.1 ng/ml in 17 patients (21.8%), and <0.10 ng/ml in 61 patients (78.8%). Patients having a cTnT level of > or =0.10 ng/ml showed significantly higher rates of MACE (64.7% vs 24.6%; p=0.003), CHF (47.1% vs 16.4%; p=0.02), and death (52.9% vs 16.4%; p=0.004). There was also a greater tendency to CAD in this group (41.2% vs 19.7%, p=0.10). In multivariate logistic regression analysis, age and diabetes mellitus were the independent predictors of MACE development.

CONCLUSION

Homocysteine levels cannot predict MACE in ESRD patients in the long-term follow-up. Despite a significantly higher incidence of MACE in patients with high cTnT levels, cTnT was not an independent predictor of cardiovascular outcome.

Authors+Show Affiliations

Department of Cardiology, Medicine Faculty of Gazi University, Ankara, Turkey. asifesah@yahoo.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19155641

Citation

Sahinarslan, Asife, et al. "Prognostic Value of Troponin T and Homocysteine in Patients With End-stage Renal Disease." Turk Kardiyoloji Dernegi Arsivi : Turk Kardiyoloji Derneginin Yayin Organidir, vol. 36, no. 6, 2008, pp. 382-7.
Sahinarslan A, Güz G, Okyay K, et al. Prognostic value of troponin T and homocysteine in patients with end-stage renal disease. Turk Kardiyol Dern Ars. 2008;36(6):382-7.
Sahinarslan, A., Güz, G., Okyay, K., Mutluay, R., Yalçin, R., Bali, M., ... Cengel, A. (2008). Prognostic value of troponin T and homocysteine in patients with end-stage renal disease. Turk Kardiyoloji Dernegi Arsivi : Turk Kardiyoloji Derneginin Yayin Organidir, 36(6), pp. 382-7.
Sahinarslan A, et al. Prognostic Value of Troponin T and Homocysteine in Patients With End-stage Renal Disease. Turk Kardiyol Dern Ars. 2008;36(6):382-7. PubMed PMID: 19155641.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prognostic value of troponin T and homocysteine in patients with end-stage renal disease. AU - Sahinarslan,Asife, AU - Güz,Galip, AU - Okyay,Kaan, AU - Mutluay,Rüya, AU - Yalçin,Ridvan, AU - Bali,Musa, AU - Sindel,Sükrü, AU - Cengel,Atiye, PY - 2009/1/22/entrez PY - 2009/1/22/pubmed PY - 2009/8/19/medline SP - 382 EP - 7 JF - Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir JO - Turk Kardiyol Dern Ars VL - 36 IS - 6 N2 - OBJECTIVES: The most important cause of increased mortality in end-stage renal disease (ESRD) is cardiovascular diseases. We investigated the prognostic value of cardiac troponin T (cTnT) and homocysteine in the long-term follow-up of ESRD patients. STUDY DESIGN: The study included 78 patients (54 males, 24 females; mean age 53.2+/-16.6 years) with ESRD, who had been on hemodialysis treatment for at least three months. Baseline troponin T and homocysteine levels were measured and the patients were followed-up from March 2002 to May 2007 for major adverse cardiovascular events (MACE). RESULTS: Major adverse cardiovascular events occurred in 26 patients (33.3%), including cerebrovascular events (n=3, 3.9%), congestive heart failure (CHF) (n=18, 23.1%), coronary artery disease (CAD) (n=19, 24.4%), and death (n=19, 24.4%). Two-thirds of diabetic patients developed MACE and the mean age in the MACE group was significantly greater (p<0.001). Troponin T levels were significantly higher in patients who developed MACE (0.21+/-0.43 ng/ml vs 0.06+/-0.28 ng/ml, p=0.002), whereas homocysteine levels did not differ significantly between the two groups (p=0.82). For a cutoff value of 0.10 ng/ml, cTnT was > or =0.1 ng/ml in 17 patients (21.8%), and <0.10 ng/ml in 61 patients (78.8%). Patients having a cTnT level of > or =0.10 ng/ml showed significantly higher rates of MACE (64.7% vs 24.6%; p=0.003), CHF (47.1% vs 16.4%; p=0.02), and death (52.9% vs 16.4%; p=0.004). There was also a greater tendency to CAD in this group (41.2% vs 19.7%, p=0.10). In multivariate logistic regression analysis, age and diabetes mellitus were the independent predictors of MACE development. CONCLUSION: Homocysteine levels cannot predict MACE in ESRD patients in the long-term follow-up. Despite a significantly higher incidence of MACE in patients with high cTnT levels, cTnT was not an independent predictor of cardiovascular outcome. SN - 1016-5169 UR - https://www.unboundmedicine.com/medline/citation/19155641/Prognostic_value_of_troponin_T_and_homocysteine_in_patients_with_end_stage_renal_disease_ L2 - https://www.journalagent.com/pubmed/linkout.asp?ISSN=1016-5169&amp;PMID=19155641 DB - PRIME DP - Unbound Medicine ER -