Serum Cardiac Troponin I: A Marker for Predicting Cardiac Mortality in Indian Chronic Kidney Disease Patients

Abstract

Excess Mortality among patients with Chronic Kidney Disease (CKD) remains high because of an excessive cardiovascular risk related to a high incidence of cardiac hypertrophy, cardiomyopathy, heart failure, and coronary artery disease. Cardiac troponins are frequently elevated in patients with end-stage renal disease (ESRD) in the absence of acute myocardial infarction. Hence, we aimed to prospectively evaluate the relationship between troponin elevations and cardiac mortality. 200 CKD patients from a private nephrology Out Patient Department (OPD) were registered in this study. 180 patients were enrolled in this present study because the 20 patients were not in regular follow up, hence excluded from the study. The patients were divided in to three groups based on the serum troponin I levels as follows: Group I : cTn I 0.09 ng/dl, Group II :cTn I 0.1-1 ng/dl and GroupII I :cTn I >1 ng/dl. Routine biochemical analysis and echocardiography were done in all the patients. Cardiac troponin I and High Sensitive C-Reactive Protein (HSCRP) were also done in all the patients.When compared to the three groups, the 3rd group patients with high cTn I concentration (6.52 ± 2.5) had ten deaths were noted during the follow-up period presumed to be cardiac cause. Conclusion: The troponin I may be an effective prognostic marker of cardiac mortality in patients with chronic kidney disease.