Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2022 Feb 1;79(4):327-336.
doi: 10.1016/j.jacc.2021.11.023.

Association of Longitudinal High-Sensitivity Troponin T With Mortality in Patients With Chronic Kidney Disease

Nicholas C Chesnaye  1 , Ehab Al-Sodany  2 , Karolina Szummer  3 , Peter Barany  2 , Olof Heimbürger  2 , Tora Almquist  4 , Stefan Melander  5 , Fredrik Uhlin  6 , Friedo Dekker  7 , Christoph Wanner  8 , Kitty J Jager  9 , Marie Evans  2
Affiliations
Observational Study

Association of Longitudinal High-Sensitivity Troponin T With Mortality in Patients With Chronic Kidney Disease

Nicholas C Chesnaye et al. J Am Coll Cardiol. .

Abstract

Background: Cardiac troponin T (cTnT) is associated with mortality in chronic kidney disease (CKD). However, the association between longitudinal cTnT measurements and survival has not previously been assessed.

Objectives: This study determined whether various parameterizations of longitudinal cTnT measurements were associated with patient survival in the older population with advanced CKD.

Methods: The EQUAL (European QUALity) study is an observational prospective cohort study that includes subjects with stage 4-5 CKD aged ≥65 years and not on dialysis. The study includes 176 participants in Sweden, where longitudinal information of cTnT was collected. The study uses joint models for longitudinal and time-to-event data to assess the longitudinal association between cTnT and survival.

Results: There were 927 cTnT measurements (median 6 per patient) collected over a median follow-up of 2.4 years. The overall 5-year survival was 57% (95% CI: 46%-69%). Longitudinally measured cTnT was associated with mortality risk, with every SD increase in cTnT, at any time point, associated with a 3.3-fold increase in mortality risk (HR: 3.3; 95% CI: 2.5-4.6). The slope of the cTnT trajectory was also associated with increased mortality risk (HR: 3.2; 95% CI: 2.0-6.0), as was the area under the cTnT trajectory (HR: 4.2; 95% CI: 2.6-7.2), which reflected the cumulative cTnT exposure.

Conclusions: Longitudinally measured cTnT is independently associated with mortality risk in older patients with stage 4 and 5 CKD, which suggests that monitoring patients with cTnT could be a valuable tool for the identification of subjects with a high mortality risk.

Keywords: chronic kidney disease; joint model; survival; troponin T.

PubMed Disclaimer

Conflict of interest statement

Funding Support and Author Disclosures Main funding was received from the European Renal Association – European Dialysis and Transplant Association (ERA-EDTA). Contributions came from the Swedish Medical Association (SLS), the Stockholm County Council ALF Medicine and Center for Innovative research (CIMED), the Italian Society of Nephrology (SIN-Reni), the Dutch Kidney Foundation (SB 142), the Young Investigators grant in Germany, and the National Institute for Health Research (NIHR) in the United Kingdom. Dr Wanner has received honoraria for consultancy and lecturing from Amicus, AstraZeneca, Bayer, Boehringer Ingelheim, Eli-Lilly, Gilead, GlaxoSmithKline, Merck Sharp & Dohme, Sanofi-Genzyme, and Takeda. Dr Evans has received payment for advisory boards and lectures by Astellas Pharma, Vifor Pharma, and AstraZeneca; and has received institutional grants from AstraZeneca and Astellas Pharma, outside of this work. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Comment in

Publication types

LinkOut - more resources