sensitive troponins – which suits better for hemodialysis patients associated factors and prediction of mortality敏感肌钙蛋白u2014u2014适合更好的血液透析患者相关因素和预测死亡率.pdfVIP

Sensitive Troponins – Which Suits Better for Hemodialysis Patients? Associated Factors and Prediction of Mortality 1 2 2 2 1 Ferruh Artunc *, Christian Mueller , Tobias Breidthardt , Raphael Twerenbold , Andreas Peter , 1 1 1 1,3 Claus Thamer , Peter Weyrich , Hans-Ulrich Haering , Bjoern Friedrich 1 Department of Internal Medicine, Division of Endocrinology, Diabetology, Vascular Disease, Nephrology and Clinical Chemistry, University of Tuebingen, Germany, 2 Department of Internal Medicine, Division of Cardiology, University of Basel, Basel, Switzerland, 3 Dialysis Center, Leonberg, Germany Abstract Background: In hemodialysis patients, elevated plasma troponin concentrations are a common finding that has even increased with the advent of newly developed sensitive assays. However, the interpretation and relevance of this is still under debate. Methods: In this cross-sectional study, we analyzed plasma concentrations of sensitive troponin I (TnI) and troponin T (TnT) in stable ambulatory hemodialysis patients (n = 239) and investigated their associations with clinical factors and mortality. Results: In all of the enrolled patients, plasma TnI or TnT was detectable at a median concentration of 14 pg/ml (interquartile range: 7–29) using the Siemens TnI ultra assay and 49 pg/ml (31–74) using the Roche Elecsys high sensitive TnT assay. Markedly more patients exceeded the 99th percentile for TnT than for TnI (95% vs. 14%, p ,0.0001). In a multivariate linear regression model, TnT was independently associated with age, gender, systolic dysfunction, time o