Association of cardiac troponin I level with in?hospital and late mortality in dialysis patients

Abstract

Background: Cardiovascular diseases (CVDs) are highly prevalent among the end?stage renal disease (ESRD) patients. Prognostic value of cardiac troponin I (cTnI) in patients with asymptomatic ESRD is less conclusive. This study was an  bservational study to evaluate correlation of first admitted cTnI level with early and late (during 6 months) hospitalization and mortality of ESRD patient admitted due to non-acute coronary and non-heart failure causes in ESRD patients.

Materials and Methods: In this prospective observational study, 460 dialysis patients without overt CVD who were admitted at two university hospital were included and followed during 6 months. Patients’ demographic information and laboratory investigations including cTnI level and cause of admission were recorded. The association between cTnI level with in?hospital and late mortality was evaluated.

Results: cTnI level was higher in female (35.9%), hemodialysis patients (28.1%), and patients with permanent catheter vascular access (29.4%). There were significant differences in level of triglyceride (TG), low?density lipoprotein (LDL) cholesterol, and high?density lipoprotein (HDL) cholesterol between patients with normal and abnormal cTnI levels (P < 0.05). Patients with abnormal cTnI levels had higher level of TG and LDL cholesterol and lower level of HDL cholesterol. cTnI levels were associated with higher in?hospital and 6?month follow?up mortality rate. In logistic regression analysis, only female gender (odds ratio [OR] =1.89, confidence interval [CI] =1.22–3.076) and TG (OR = 1.007, CI = 1.003–1.01) were positively and HDL cholesterol level (OR = 0.994, CI = 0.98–0.99) was negatively associated with increased cTnI level. cTnI level was associated with early (OR = 4.81, CI = 1.64–14.89) and late (OR = 4.31, CI = 1.61–10.96) mortality.

Conclusion: Although in this study, cTnI level is not directly associated with cardiovascular disorders and admission and readmission causes, it is a strong predictor of early and late mortality.