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Association Between Renal Function and Troponin T Over Time in Stable Chronic Kidney Disease Patients

2019; Wiley; Volume: 8; Issue: 21 Linguagem: Inglês

10.1161/jaha.119.013091

2047-9980

Nicholas C. Chesnaye, Karolina Szummer, Peter Bárány, Olof Heimbürger, Hasan Mağın, Tora Almquist, Fredrik Uhlin, Friedo W. Dekker, Christoph Wanner, Kitty J. Jager, Marie Evans, Adamasco Cupisti, Adelia Sagliocca, Alberto Ferraro, Aleksandra Musiała, Alessandra Mele, Alessandro Naticchia, Alex Còsaro, Alistair Woodman, Andrea Ranghino, Andrea Stucchi, Andreas Jönsson, Andreas Schneider, Angelo Pignataro, Anita Schrander, Anke Torp, Anna McKeever, Maciej Szymczak, Anna‐Lena Blom, Antonella De Blasio, Antonello Pani, Aris Tsalouichos, Asad Ullah, Barbara A. McLaren, Bastiaan van Dam, Beate Iwig, Antonio Bellasi, Biagio Di Iorio, Björn Rogland, Boris Perras, Butti Alessandra, Camille Harron, Carin Wallquist, C. E. H. Siegert, Carla Barrett, Sandrine Gaillard, Cataldo Abaterusso, Charles Beerenhout, Charlotte O’Toole, Chiara Somma, Christian Marx, Christiane Drechsler, Christina Summersgill, Christof Blaser, Claudia D’Alessandro, Claudia Emde, Claudia Torino, Claudia Zullo, Claudio Pozzi, Colin Geddes, Cornelis A. Verburgh, Cynthia Janmaat, Daniela Bergamo, Daniele Ciurlino, Daria Motta, Deborah Glowski, Deborah McGlynn, Denes Vargas, Detlef H. Krieter, Domenico Russo, Dunja Fuchs, Dympna Sands, Ellen K. Hoogeveen, Ellen Irmler, Emöke Dimény, Enrico Favaro, Eva Platen, Ewelina Olczyk, Ewout J. Hoorn, Federica Neve Vigotti, Fergus Caskey, Ferruccio Ansali, Ferruccio Conte, Francesca Cianciotta, Francesca Giacchino, Francesco Cappellaio, Francesco Pizzarelli, Fredrik Sundelin, Gaetano Greco, Geena Roy, Gaetana Porto, Giada Bigatti, Giancarlo Marinangeli, Gianfranca Cabiddu, Gillian L. Hirst, Giordano Fumagalli, Giorgia Apollonia Caloro, Giorgina Barbara Piccoli, Giovambattista Capasso, Giovanni Gambaro, Giuliana Tognarelli, Giuseppe Bonforte, Giuseppe Conte, Giuseppe Toscano, Goffredo Del Rosso, Gunilla Welander, Hanna Augustyniak‐Bartosik, Johannes Boots, Hans Schmidt‐Gürtler, H.D. King, Helen McNally, Hendrik Schlee, Henk Boom, Holger Naujoks, Houda Masri‐Senghor, Hugh Murtagh, Hugh C. Rayner, Ilona Miśkowiec‐Wiśniewska, Ines Schlee, Irene Capizzi, Sabine Cäsar, Isabel Bascaran Hernandez, Ivano Baragetti, Jacek Manitius, Jane Turner, Jan‐Willem Eijgenraam, Jeroen P. Kooman, Joachim Beige, Joanna Pondel, Joanne Wilcox, Jocelyn Berdeprado, Jochen Röthele, Jonathan W.C. Wong, Jan Rotmans, Joyce Banda, Justyna Mazur, Kai Hahn, Kamila Jędrzejak, Katarzyna Nowańska, Katja Blouin, Katrin Neumeier, Kirsteen Jones, Kirsten Anding‐Rost, Knut‐Christian Gröntoft, Lamberto Oldrizzi, Lesley Haydock, Liffert Vogt, Lily Wilkinson, Loreto Gesualdo, Lothar Schramm, Luigi Biancone, Łukasz R. Nowak, Maarten Raasveld, Maciej Szymczak, Magdalena Durlik, Manuela Magnano, Marc G. Vervloet, Marco Ricardi, Margaret Carmody, María Di Bari, Maria Laudato, Maria Luisa Sirico, Maria Stendahl, Maria Svensson, Maria Weetman, Marjolijn van Buren, Martin Joinson, Martina Ferraresi, Mary Ann Dutton, Maurizio Postorino, Merel van Diepen, Michael R. Matthews, Michele Provenzano, Monika Hopf, Moreno Malaguti, Nadja Wuttke, N. O. Morgan, Nicola Palmieri, Nikolaus Frischmuth, Nina Bleakley, Paola Murrone, Paul Cockwell, Paul Leurs, Paul Roderick, Pauline Voskamp, Pavlos Kashioulis, Pawlos Ichtiaris, Peter J. Blankestijn, Petra Kirste, Petra Schulz, Phil Mason, Philip A. Kalra, Pietro Cirillo, Pietro Dattolo, Pina Acampora, Rincy Sajith, Rita Nigro, R Boero, Roberto Scarpioni, Rosa Sicoli, Rosella Malandra, Sabine Aign, Sadie van Esch, Sally Chapman, Sandra Biribauer, Santee Navjee, Sarah Crosbie, Sharon Brown, Sheila Tickle, Sherin Manan, Silke Röser, Silvana Savoldi, Silvio Bertoli, Silvio Borrelli, Siska Boorsma, Stefan Heidenreich, Stefan Melander, Stefania Maxia, Stefano Maffei, Stefano Mangano, Stephanie Palm, Constantijn Konings, Suresh Mathavakkannan, Susanne Schwedler, Sylke Delrieux, Sylvia Renker, Sylvia Schättel, Szyszkowska Dorota, Teresa Cicchetti, Teresa Nieszporek, Theresa Stephan, Thomas Schmiedeke, Thomas Weinreich, Til Leimbach, Tiziana Rappa, Torsten Stövesand, Udo Bahner, Ulrika Jensen, Valentina Palazzo, Walter De Simone, Werner Seeger, Ying Kuan, Zbigniew Heleniak, Zeynep Gökçe Gayretli Aydın,

Cardiovascular Function and Risk Factors

Background People with reduced glomerular filtration rate (GFR) often have elevated cardiac troponin T (cTnT) levels. It remains unclear how cTnT levels develop over time in those with chronic kidney disease (CKD). The aim of this study was to prospectively study the association between cTnT and GFR over time in older advanced‐stage CKD patients not on dialysis. Methods and Results The EQUAL (European Quality Study) study is an observational prospective cohort study in stage 4 to 5 CKD patients aged ≥65 years not on dialysis (incident estimated GFR, <20 mL/min/1.73 m²). The EQUAL cohort used for the purpose of this study includes 171 patients followed in Sweden between April 2012 and December 2018. We used linear mixed models, adjusted for important groups of confounders, to investigate the effect of both measured GFR and estimated GFR on high‐sensitivity cTnT (hs‐cTnT) trajectory over 4 years. Almost all patients had at least 1 hs‐cTnT measurement elevated above the 99th percentile of the general reference population (≤14 ng/L). On average, hs‐cTnT increased by 16%/year (95% CI, 13–19; P <0.0001). Each 15 mL/min/1.73 m 2 lower mean estimated GFR was associated with a 23% (95% CI, 14–31; P <0.0001) higher baseline hs‐cTnT and 9% (95% CI, 5–13%; P <0.0001) steeper increase in hs‐cTnT. The effect of estimated GFR on hs‐cTnT trajectory was somewhat lower than a previous myocardial infarction (15%), but higher than presence of diabetes mellitus (4%) and male sex (5%). Conclusions In CKD patients, hs‐cTnT increases over time as renal function decreases. Lower CKD stage (each 15 mL/min/1.73 m 2 lower) is independently associated with a steeper hs‐cTnT increase over time in the same range as other established cardiovascular risk factors.