Kidney Res Clin Pract.  2017 Dec;36(4):358-367. 10.23876/j.krcp.2017.36.4.358.

Prognostic performance of combined use of high-sensitivity troponin T and creatine kinase MB isoenzyme in high cardiovascular risk patients with end-stage renal disease

• Ahmed KA
• Al-Attab W

• KMID: 2405111
• DOI: http://doi.org/10.23876/j.krcp.2017.36.4.358

Abstract

BACKGROUND
The principal goal of this study was to determine the importance of high-sensitivity troponin T (hs-TnT) and creatine kinase MB isoenzyme (CK-MB) in predicting cardiovascular events in asymptomatic end-stage renal disease (ESRD) patients.
METHODS
This study included 110 participants; 54 ESRD patients undergoing hemodialysis and 56 healthy control participants. Biochemical parameters and cardiac markers were estimated. Comparative utilities were assessed through logistic regression and receiver operating characteristic (ROC) analyses.
RESULTS
We found that 96.3% of ESRD patients had an elevated level of hs-TnT (mean, 0.049 ± 0.0324 μg/L) compared to healthy participants. Among patients with ESRD, hs-TnT showed significant correlations with the low-density lipoprotein cholesterol/high-density lipoprotein cholesterol (HDL-C) (P = 0.042, r = 0.278) and total cholesterol/HDL-C (P = 0.044, r = 0.276) ratios. CK-MB (odds ratio [OR], 1.138; P = 0.04) and hs-TnT (OR, 2.153; P = 0.017) predicted cardiovascular events on logistic regression analysis, and the prediction was improved by the model that combined two cardiac markers. The diagnostic performance of hs-TnT and CK-MB alone and the combination of the two biomarkers was assessed by the area under the ROC curve (AUC). The highest AUC was produced by the combination of hs-TnT and CK-MB markers (0.920) compared to hs-TnT or CK-MB alone.
CONCLUSION
In asymptomatic patients with ESRD, hs-TnT appeared to be an important predictor for cardiovascular mortality, and its diagnostic accuracy improved with CK-MB. This study provides new insights into the predictive value of multiple biomarkers for identifying cardiovascular events in ESRD patients on hemodialysis.

Keyword

Cardiovascular diseases; Creatine kinase MB isoenzyme; End-stage renal disease; High-sensitivity troponin T

MeSH Terms

Area Under Curve
Biomarkers
Cardiovascular Diseases
Cholesterol
Creatine Kinase*
Creatine*
Healthy Volunteers
Humans
Kidney Failure, Chronic*
Lipoproteins
Logistic Models
Mortality
Renal Dialysis
ROC Curve
Troponin T*
Troponin*
Biomarkers
Cholesterol
Creatine
Creatine Kinase
Lipoproteins
Troponin
Troponin T