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- Ruth F Dubin, Yongmei Li, Jiang He, Bernard G Jaar, Radhakrishna Kallem, James P Lash, Gail Makos, Sylvia E Rosas, Elsayed Z Soliman, Ray R Townsend, Wei Yang, Alan S Go, Martin Keane, Christopher Defilippi, Rakesh Mishra, Myles Wolf, Michael G Shlipak, and CRIC Study Investigators.
- San Francisco VA Medical Center, University of California San Francisco, 4150 Clement Street, Box 111A1, San Francisco, CA 94121, USA. ruth.dubin@ucsf.edu.
- Bmc Nephrol. 2013 Jan 1; 14: 229.
BackgroundCardiac troponin T is independently associated with cardiovascular events and mortality in patients with chronic kidney disease (CKD). Serum levels of high sensitivity cardiac troponin T (hs-TnT) reflect subclinical myocardial injury in ambulatory patients. We sought to determine the distribution and predictors of hs-TnT in CKD patients without overt cardiovascular disease (CVD).MethodsWe studied 2464 participants within the multi-ethnic Chronic Renal Insufficiency Cohort (CRIC) who did not have self-reported CVD. We considered renal and non-renal factors as potential determinants of hs-TnT, including demographics, comorbidities, left ventricular (LV) mass, serologic factors, estimated glomerular filtration rate (eGFR) and albumin to creatinine ratio.ResultsHs-TnT was detectable in 81% of subjects, and the median (IQR) hs-TnT was 9.4 pg/ml (4.3-18.3). Analysis was performed using Tobit regression, adjusting for renal and non-renal factors. After adjustment, lower eGFR was associated with higher expected hs-TnT; participants with eGFR < 30 ml/min/1.73 m(2) had 3-fold higher expected hs-TnT compared to subjects with eGFR > 60. Older age, male gender, black race, LV mass, diabetes and higher blood pressure all had strong, independent associations with higher expected hs-TnT.ConclusionsKnowledge of the determinants of hs-TnT in this cohort may guide further research on the pathology of heart disease in patients with CKD and help to stratify sub-groups of CKD patients at higher cardiovascular risk.
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