High‐Sensitivity Troponin T and C‐Reactive Protein Have Different Prognostic Values in Hemo‐ and Peritoneal Dialysis Populations: A Cohort Study

Chen, Titi; Hassan, Hicham I. Cheikh; Qian, Pierre; Vu, Monica; Makris, Angela

doi:10.1161/jaha.117.007876

Cited by 28 publications

(29 citation statements)

References 43 publications

(96 reference statements)

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“…As previously emphasised, in patients with ESRD, serum troponin concentrations tend to be higher than in the general population even in the absence of acute events. Recently, many authors have dedicated themselves to the evaluation of the prognostic significance of cardiac troponin levels in patients with ESRD [23]. Moreover, it should be highlighted that CRP has been found elevated in patients with NAFLD [24].…”

Section: Discussionmentioning

confidence: 99%

Troponin Levels Relate to CRP Concentrations in Patients With NAFLD on Maintenance Haemodialysis: A Retrospective Study

Capone

Vinciguerra

Ragosta³

et al. 2020

Adv Ther

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Introduction: Several studies have shown that high sensitivity cardiac troponin (hs-cTnT) levels are elevated in patients suffering from end-stage renal disease (ESRD), even in the absence of clinical signs and instrumental features of symptomatic acute coronary syndrome (ACS). In patients undergoing haemodialysis because of ESRD, nephrologists bear witness to this increase, whose origin and clinical impact are not yet well defined. Methods: By a retrospective study, we evaluated data from records of 70 patients with ESRD on haemodialysis, all of them with a history of NAFLD, not suffering for at least 3 months from symptomatic angina and without a history of ischemic heart disease in the same period. Results: Hs-cTnT and C-reactive protein (CRP) levels both increased and were correlated, rho = 0.34, P = 0.004. The correlation coefficient between troponin and age was significant, rho = 0.47, P = 0.0001. Serum concentrations of hs-cTnT for the whole population were positively predicted by CRP levels, P = 0.004. On separation of the population by gender, significant correlation between hs-cTnT and CRP was not found in women and was only present in men, P = 0.66 and P = 0.000, respectively. Discussion: The assessment of hs-cTnT levels could represent a biological marker in particular subgroups of haemodialysis patients, especially for male patients with higher CRP, those at greater risk of silent myocardial ischemia and future major adverse cardiac events. Conclusions: The evaluation of hs-cTnT in haemodialysed patients with NAFLD could indicate that men with higher CRP should undergo close monitoring in order to adopt specific therapy.

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Section: Discussionmentioning

confidence: 99%

Troponin Levels Relate to CRP Concentrations in Patients With NAFLD on Maintenance Haemodialysis: A Retrospective Study

Capone

Vinciguerra

Ragosta³

et al. 2020

Adv Ther

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“…hs-CRP is one of the earliest and most frequently used biomarkers. The positive association between hs-CRP level and CVD events, as well as overall morality in CKD patients, is evident [24][25][26], although some still debate its clinical application [27]. Some other parameters have also been suggested to serve this purpose, such as microalbuminuria, natriuretic peptides, troponins, adiponectin, leptin, phosphorus, parathyroid hormone, vitamin D, fibroblast growth factor 23, and matrix metalloproteinases [27,28].…”

Section: Possibility Of Using Hs-crp In Risk Stratification For Rimentioning

confidence: 99%

High-Sensitivity C-Reactive Protein Elevation Is Independently Associated with Subclinical Renal Impairment in the Middle-Aged and Elderly Population—A Community-Based Study in Northern Taiwan

Chuang

Lin

et al. 2020

IJERPH

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This cross-sectional study aimed to investigate the associations between high-sensitivity C-reactive protein (hs-CRP) and renal impairment (RI) among middle-aged and elderly people. We collected and analyzed demographic, anthropometric, metabolic, and renal function data in a community-based population in Northern Taiwan. We excluded subjects with acute inflammation from this study and defined RI as the presence of urinary albumin–creatinine ratio 30–300 mg/g or an estimated glomerular filtration rate of <60 mL/min/1.73 m2. There were 131, 125, and 125 participants in the low (≤0.80 mg/L), middle (0.81–1.76 mg/L), and high (>1.77 mg/L) hs-CRP tertiles, respectively. hs-CRP exhibited significantly positive correlations with body mass index, waist circumference, systolic blood pressure, triglyceride, and fasting plasma glucose, and a negative correlation with high-density lipoprotein. The prevalence and odds ratio of RI significantly increased across hs-CRP tertiles from low to high, and this trend remained significant after adjusting for the conventional cardiometabolic risk factors. hs-CRP ≥ 1.61 mg/L in the total group and ≥2.03 mg/L in the elderly group accurately predicted RI (p = 0.01 and 0.03, respectively). These findings suggest that we should carefully evaluate the renal function for at-risk individuals with hs-CRP elevation.

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“…MACE was defined as cardiac death, nonfatal myocardial infarction, or target lesion revascularization. 17 Myocardial infarction was defined by a rise in high sensitivity troponin T (>20% increase from previous baseline) in addition to ischaemic symptoms, new electrocardiogram changes or identification of an intracoronary thrombus by angiography. 18 Data collection was undertaken by three investigators (SN, LG & PL) and a protocol was developed to ensure agreement on consistent and accurate methods for data collection.…”

Section: Data Collectionmentioning

confidence: 99%

“…Median eGFR at baseline for all patients was 16 mL/min/1.73 m 2 (interquartile range (IQR) = 13-20) and there was a significant difference between the DC and no-DC groups (DC group median 17 (IQR = 14-22) versus no-DC group median 15 [12][13][14][15][16][17][18][19] ; P = 0.005). Patients received DC at a median time of 39 days (IQR 0-99 days) post-initial education with the pre-dialysis nurse.…”

Section: Baseline Characteristicsmentioning

confidence: 99%

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The association between dietetic consultation and time to dialysis for patients attending a pre‐dialysis clinic: A retrospective cohort study

et al. 2019

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Aim A multidisciplinary approach, including dietetics, is considered the optimal model of care for dialysis preparation. Dietetic consultation (DC) focuses on symptom management and dietary changes to delay time to dialysis. Evidence of the effectiveness of DC on time to dialysis is limited. This study aimed to investigate the impact of DC on time to dialysis for patients attending a pre‐dialysis clinic. Methods A retrospective cohort study was designed to include all patients attending outpatient pre‐dialysis clinics at a large metropolitan renal service between January 2014 and March 2018. Time to dialysis (days) was compared between patients that received DC and those who did not. Cox proportional hazards analysis allowing for adjustment of differences and confounders was undertaken. Results A cohort of 246 patients was identified. Median estimated glomerular filtration rate was 16mL/min per 1.73 m2 (interquartile range = 13–20) at initial pre‐dialysis clinic visit and 63% commenced dialysis during the study period. Only 41% of patients received dietetic consultation. Significantly fewer patients needed to commence dialysis in the DC group compared to the no‐DC group (hazards ratio 0.63; 95% confidence interval (CI) 0.45–0.89; P = 0.008 Cox proportion hazard). The DC group commenced dialysis significantly later than the no‐DC group; 933 days (95% CI 832–1034) versus 710 days (95% CI 630–790) respectively, after the initial pre‐dialysis clinic visit; log–rank 0.005. Conclusion DC provided to patients attending a pre‐dialysis clinic was associated with a delayed time to dialysis. Standardised referral pathways to improve patient access to renal dietetic services are recommended to optimise care.

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High‐Sensitivity Troponin T and C‐Reactive Protein Have Different Prognostic Values in Hemo‐ and Peritoneal Dialysis Populations: A Cohort Study

Cited by 28 publications

References 43 publications

Troponin Levels Relate to CRP Concentrations in Patients With NAFLD on Maintenance Haemodialysis: A Retrospective Study

Troponin Levels Relate to CRP Concentrations in Patients With NAFLD on Maintenance Haemodialysis: A Retrospective Study

High-Sensitivity C-Reactive Protein Elevation Is Independently Associated with Subclinical Renal Impairment in the Middle-Aged and Elderly Population—A Community-Based Study in Northern Taiwan

The association between dietetic consultation and time to dialysis for patients attending a pre‐dialysis clinic: A retrospective cohort study

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