Factors Related to Silent Myocardial Damage in Hemodialysis Patients

Figures & data

Table 1  Comparative baseline characteristics of hemodialysis patients with normal and elevated cardiac troponin I levels

	Group 1: cTnI <2.3 ng/ml (n = 103)	Group 2: cTnI ≥2.3 ng/ml (n = 10)	p
Smoker/nonsmoker	38 / 65	3 / 7	0.745
Diabetes mellitus (P/A)	15 / 88	3 / 7	0.197
Atherosclerosis (P/A)	40 / 63	6 / 4	0.312
Coronary artery disease (P/A)	33 / 70	5 / 5	0.300
Peripheral artery disease (P/A)	12 / 91	3 / 7	0.128
Cerebrovascular disease (P/A)	5 / 98	1 / 9	0.434
Statin usage (P/A)	29 / 74	4 / 6	0.474
Left ventricular hypertrophy (P/A)	37 / 66	7 / 3	0.045
Anti-hypertensive medication (P/A)	52 / 51	3 /7	0.323

Abbreviations: cTnI = cardiac troponin I, P/A = present/absent.

Table 2  The comparative demographic and clinical parameters of hemodialysis patients with normal and elevated cardiac troponin I levels

	Group 1: cTnI <2.3 ng/ml (n = 103)	Group 2: cTnI ≥2.3 ng/ml (n = 10)	p
Age (years)	50.0 ± 11.9	60.2 ± 7.6	0.008
Dialysis duration (months)	96 (8–220)	93 (72–144)	0.852
Body mass index (kg/m^2)	23.5 ± 3.8	22.5 ± 2.2	0.447
Systolic blood pressure (mmHg)	134.9 ± 17.4	146.6 ± 14.2	0.056
Diastolic blood pressure (mmHg)	81.8 ± 13.7	88.5 ± 9.7	0.199
nPNA (g/kg/day)	1.29 ± 0.20	1.18 ± 0.14	0.094
spKt/V	1.35 ± 0.14	1.30 ± 0.05	0.390

Abbreviations: cTnI = cardiac troponin I, nPNA = normalized protein equivalent of total nitrogen appearance.

Table 3  Comparative laboratory parameters of hemodialysis patients with normal and elevated cardiac troponin I levels

	Group 1: cTnI <2.3 ng/ml (n = 103)	Group 2: cTnI≥2.3 ng/ml (n = 10)	p
Hemoglobin (g/L)	113.0 ± 12.0	100.0 ± 9.0	0.002
Glucose (mmol/L)	5.2 ± 1.1	5.4 ± 1.1	0.264
Albumin (g/L)	40.0 ± 3.8	38 ± 3.7	0.110
Prealbumin (mg/dl)	32.7 ± 11.2	25.9 ± 13.1	0.154
C-reactive protein (mg/L)	4.1 (0.37–23.7)	9.4 (2.2–19.5)	0.003
Blood urea nitrogen (mmol/L)	26.8 ± 5.4	25.0 ± 4.5	0.302
Creatitine (μmol/L)	813.3 ± 123.8	813.3 ± 79.6	0.887
Uric acid (μmol/L)	410.0 ± 65.4	386.7 ± 59.5	0.227
Calcium (mmol/L)	2.3 ± 0.2	2.3 ± 0.1	0.875
Phosphorus (mmol/L)	1.7 ± 0.4	1.4 ± 0.4	0.058
Total cholesterol (mmol/L)	4.70 ± 1.16	4.64 ± 1.06	0.952
HDL-C (mmol/L)	1.25 ± 0.28	0.93 ± 0.32	0.002
LDL-C (mmol/L)	2.60 ± 0.82	2.46 ± 0.67	0.653
Triglyceride (mmol/L)	1.8 (0.4–5.0)	2.0 (0.5–2.5)	0.701
Iron (μmol/L)	12.4 (1.4–39.4)	12.1 (6.1–25.2)	0.804
Ferritin (ng/ml)	260.5 (17–1342)	254 (123–695)	0.744
Transferrin (μg/dl)	164.7 ± 42.7	171.7 ± 46.5	0.952
Intact PTH (ng/ml)	281 (17–999)	313.5 (21.5–689)	0.864
Homocystein (μmol/l)	10.3 ± 7.5	10.0 ± 4.9	0.578
TNF-α (pg/ml)	12.8 ± 4.5	17.3 ± 4.5	0.005

Abbreviations: cTnI = cardiac troponin I, HDL-C = high-density lipoprotein cholesterol, LDL-C = low-density lipoprotein cholesterol, PTH = parathyroid hormone, TNF-α = tumor necrosis factor-alpha.

Figure 1. The regression graphic between cardiac troponin I and tumor necrosis factor-alpha.

Figure 2. The regression graphic between cardiac troponin I and normalized protein equivalent of total nitrogen appearance.

Figure 3. The regression graphic between cardiac troponin I and hemoglobin.

Table 4  Backward multiple linear regression analysis of factors that may be associated with high log cTnI

	B	Beta	95% CI	p
Diabetes mellitus	+0.305	+0.160	0.046–0.565	0.021
Left ventricular hypertrophy	+0.356	+0.247	0.163–0.549	<0.0001
Uncontrolled blood pressure	+0.246	+0.170	0.047–0.444	0.016
nPNA	−0.834	−0.230	−1.328 – −0.340	0.001
Hemoglobin	−0.169	−0.302	−0.242 – −0.096	<0.0001
TNF-α	+0.076	+0.506	0.057–0.097	<0.0001

Abbreviations: cTnI = cardiac troponin I, CI = confidence interval, nPNA = normalized protein nitrogen appearance, TNF-α = tumor necrosis factor-alpha.