Troponin-I is not falsely elevated in asymptomatic dialysis patients

Abstract EN

Dialysis patients with troponin-I levels above the cut-off value diagnostic for acute myocardial event (AME) are sometimes labeled as having “ renal cause ” of elevated troponin-I.

Patients with troponin-I levels above 0.0 ng / mL, but below the cut-off level for an AME, are reported to have increased risk for coronary heart disease and mortality.

Single pre-dialysis blood samples were taken from 150 asymptomatic dialysis patients (on hemo- or peritoneal dialysis) for troponin-I, cardiac enzymes, C-reactive protein (CRP) and lipid parameters.

Troponin-I was measured by a chemiluminescent microparticle immunoassay (CMIA), of which the cut-off value for AME was set at ≥ 0.4 ng / mL.

Patients with troponin-I levels of 0.0 ng / mL, and those with levels between 0.1 and 0.3 ng / mL, were compared regarding their cardiovascular risk profile.

None of the patients had troponin-I concentrations above the cut-off level diagnostic for an AME, with 85.3 % of the patients having levels of 0.0 ng / mL.

While there was no difference in the “ traditional ” risk factors such as age, body mass index, prevalence of diabetes mellitus, hypertension, total cholesterol and low-density lipoprotein cholesterol between patients with troponin-I levels of 0.1–0.3 ng / mL and those with levels of 0.0 ng / mL, CRP concentrations were higher in the former.

In peritoneal dialysis patients, the weekly Kt / V was lower in the patients with troponin levels between 0.1 and 0.3 ng / mL.

The findings should add strong support in settling the debate of whether or not in patients on dialysis, falsely elevated levels of troponin-I “ commonly ” occur.

An increased level of CRP and lower Kt / V might add to the cardiovascular risk in patients with troponin-levels between 0.1 and 0.3 ng / mL.