Longitudinal high-sensitivity troponin T predicts mortality in CKD

An independent association exists between longitudinally measured cardiac troponin T (cTnT) and mortality risk in older patients with stage 4 and 5 chronic kidney disease (CKD), reveals a study. This suggests that monitoring patients with cTnT may serve well in identifying those with a high death risk.

A team of investigators conducted an observational prospective cohort study to determine whether various parameterizations of longitudinal cTnT measurements were associated with patient survival in older individuals (≥65 years of age) with advanced CKD and not on dialysis. Overall, 176 participants in Sweden were included, among whom longitudinal information of cTnT was obtained.

The investigators used joint models for longitudinal and time-to-event data to examine the longitudinal association between cTnT and survival.

Over a median follow-up of 2.4 years, a total of 927 cTnT measurements (median 6 per patient) were collected. Five-year survival overall was 57 percent (95 percent confidence interval [CI], 46‒69).

Longitudinally measured cTnT correlated with mortality risk: every SD increase in cTnT at any time point was associated with a 3.3-fold increase in mortality risk (hazard ratio [HR], 3.3, 95 percent CI, 2.5‒4.6).

The slope of cTnT trajectory also correlated with higher mortality risk (HR, 3.2, 95 percent CI, 2.0‒6.0), as did the area under the cTnT trajectory (HR, 4.2, 95 percent CI, 2.6‒7.2), which reflected the cumulative cTnT exposure.

“CTnT is associated with mortality in CKD,” the investigators noted.