In patients with ESRD, deaths due to cardiac causes account for nearly 40 to 45 percent of all deaths. Hence cardiac risk stratification remains a challenge for the clinicians. Elevated levels of C reactive protein levels( CRP), indicative of inflammation are high in as much as 70% patients receiving dialysis. Levels of cardiac troponin are also high in ESRD patients, irrespective of the manifestation of the symptoms related to cardiac myopathies. To understand the relation between ESRD and cardiac biomarkers, a prospective multicentre study was undertook encompassing patients undergoing long term haemodialysis.
The study was conducted in various regions of Texas, across community centres and university hospitals. To be enrolled, a patient …show more content…
A 2.5 times higher risk of death was found in the patients having both the markers with higher levels. For only one marker level reported high, the risk of death was between that of both low and both high. In patients with low CRP, irrespective of troponin t level, there was no definable risk present. In patients with high CRP, the level of troponin t discriminated those at higher risk for cardiac death, with higher troponin t being more hazardous. Nearly half of all cardiac deaths showed co-occurrence of high levels of both troponin t and CRP. The analysis was also stratified along with presence or absence of a history of CAD and by white race which showed no relation with biomarkers whatsoever. Coronary angiographic findings from sixty seven patients were recorded and, no significant clinical differences were found between those who underwent angiography and those who did not, except for a lower age and moderately lower kt/v in the former. No differences in the levels of troponin t and CRP were found. In echocardiograms, the prevalence of LV hypertrophy and systolic dysfunction was assessed along with troponin t and CRP quartiles. No trend was found for LV hypertrophy, but depressed systolic function was quite high in patients in the highest troponin t
The study was conducted in various regions of Texas, across community centres and university hospitals. To be enrolled, a patient …show more content…
A 2.5 times higher risk of death was found in the patients having both the markers with higher levels. For only one marker level reported high, the risk of death was between that of both low and both high. In patients with low CRP, irrespective of troponin t level, there was no definable risk present. In patients with high CRP, the level of troponin t discriminated those at higher risk for cardiac death, with higher troponin t being more hazardous. Nearly half of all cardiac deaths showed co-occurrence of high levels of both troponin t and CRP. The analysis was also stratified along with presence or absence of a history of CAD and by white race which showed no relation with biomarkers whatsoever. Coronary angiographic findings from sixty seven patients were recorded and, no significant clinical differences were found between those who underwent angiography and those who did not, except for a lower age and moderately lower kt/v in the former. No differences in the levels of troponin t and CRP were found. In echocardiograms, the prevalence of LV hypertrophy and systolic dysfunction was assessed along with troponin t and CRP quartiles. No trend was found for LV hypertrophy, but depressed systolic function was quite high in patients in the highest troponin t