ISSN 1016-5169 | E-ISSN 1308-4488
Archives of the Turkish Society of Cardiology
Prognostic value of troponin T and homocysteine in patients with end-stage renal disease [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2008; 36(6): 382-387

Prognostic value of troponin T and homocysteine in patients with end-stage renal disease

Asife Şahinarslan1, Galip Güz2, Kaan Okyay1, Rüya Mutluay2, Rıdvan Yalçın1, Musa Bali2, Şükrü Sindel2, Atiye Çengel1
1Department of Cardiology, Medicine Faculty of Gazi University, Ankara
2Department of Nephrology, Medicine Faculty of Gazi University, Ankara

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.

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).

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 ≥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 ≥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.

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.

Keywords: Biological markers/blood, cardiovascular diseases, homocysteine/blood; kidney failure, chronic/complications; renal dialysis; troponin T/blood.

How to cite this article
Asife Şahinarslan, Galip Güz, Kaan Okyay, Rüya Mutluay, Rıdvan Yalçın, Musa Bali, Şükrü Sindel, Atiye Çengel. Prognostic value of troponin T and homocysteine in patients with end-stage renal disease. Turk Kardiyol Dern Ars. 2008; 36(6): 382-387

Corresponding Author: Asife Şahinarslan, Türkiye
Manuscript Language: English

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