The Relationship between Serum Concentration of Cardiac Troponin I in Chronic Renal Failure Patients and Cardiovascular Events
Kitigon Vichairuangthum MD*, Wattana Leowattana MD**, Leena Ong-Ajyooth MD***, Sasikant Pokum BSc**
Affiliation : * Department of Clinical Pathology, Faculty of Medicine Siriraj Hospital, Mahidol University ** Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University *** Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University
Objective : The purpose of this study was to evaluate the relationship between serum cardiac troponin I in
asymptomatic chronic renal failure patients and cardiovascular events.
Background : Short-term follow-up studies on this subject produced conflicting results.
Materials and Methods : A total of 63 asymptomatic patients with chronic renal failure (CRF) with regular
hemodialysis were followed for 18 months for cardiac mortality, myocardial infarction events and interventional
procedures such as percutaneous transluminal coronary angioplasty (PTCA) and coronary artery bypass
graft (CABG). Serum cTnI and other blood chemistries were measured at the time of the study.
Results : Forty seven chronic dialysis patients (75%) had an elevated level of cTnI concentration more than
the 0.08 ng/ml cutoff but only fourteen patients (22%) had and elevated cTnI concentration of more than the
AMI cutoff (0.4ng/ml). When using the 0.08 ng/ml cutoff, the NT-proBNP concentrations of the elevated groups
were significantly higher than the normal groups. The authors also found that the elevated groups above the
AMI cutoff had significantly higher cardiovascular events.
Conclusion : Elevated cTnI concentrations are commonly found in chronic renal failure patients. The AMI
cutoff level of cTnI (0.4 ng/ml) seem to have a benefit for predicting the cardiovascular events in asymptomatic
chronic renal failure patients while the 0.08 ng/ml cutoff doesn’t have usefulness for this purpose. Further
studies are needed to clarify this hypothesis.
Keywords : Chronic renal failure, Cardiovascular events, cTnI, NT-proBNP
