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Troponin I is an independent predictor of cardiovascular events and mortality in haemodialysis patients

Patients with end-stage kidney disease (ESKD) undergoing haemodialysis (HD) have a high risk of cardiovascular (CV) events. This study evaluated troponin I (hs-cTnI) as a predictor of major adverse cardiac events (MACEs), CV death and all-cause death.The AURORA trial, a multicentre, randomized, doub...

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Main Authors: Tydén, Maria (Author) , Westerlund, Magnus E (Author) , Duarte, Kevin (Author) , Eriksson, Niclas (Author) , Girerd, Nicolas (Author) , Krämer, Bernhard (Author) , März, Winfried (Author) , Rossignol, Patrick (Author) , Scharnagl, Hubert (Author) , Soveri, Inga (Author) , Svensson, Maria K (Author) , Zannad, Faiez (Author) , Fellström, Bengt (Author)
Format: Article (Journal)
Language:English
Published: April 2025
In: Clinical kidney journal
Year: 2025, Volume: 18, Issue: 4, Pages: 1-10
ISSN:2048-8513
DOI:10.1093/ckj/sfaf047
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.1093/ckj/sfaf047
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Author Notes:Maria Tydén, Magnus E Westerlund, Kevin Duarte, Niclas Eriksson, Nicolas Girerd, Bernhard K Krämer, Winfried März, Patrick Rossignol, Hubert Scharnagl, Inga Soveri, Maria K Svensson, Faiez Zannad and Bengt Fellström
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Summary:Patients with end-stage kidney disease (ESKD) undergoing haemodialysis (HD) have a high risk of cardiovascular (CV) events. This study evaluated troponin I (hs-cTnI) as a predictor of major adverse cardiac events (MACEs), CV death and all-cause death.The AURORA trial, a multicentre, randomized, double-blind trial involved 2776 HD patients comparing rosuvastatin with placebo. No significant effect was found on the composite primary endpoint of CV death, non-fatal myocardial infarction or non-fatal stroke. In this post hoc analysis, we analysed the association between baseline hs-cTnI and outcomes using Cox regression analyses. We adjusted for multiple background factors and available biomarkers. Hs-cTnI was log2-transformed and modelled using a four-knot restricted cubic spline. Variables were ordered by their importance in the models using χ2 value minus degrees of freedom.Baseline median hs-cTnI was 17.3 pg/mL. During follow-up, 734 MACEs, 598 CV deaths, and 1094 total deaths occurred. Patients in the upper quartile of hs-cTnI (>32.6 pg/mL) had significantly higher risk of MACEs [hazard ratio (HR) 1.92; 95% confidence interval (CI) 1.57-2.35], CV death (HR 2.12; 95% CI 1.69-2.66), all-cause death (HR 1.84; 95% CI 1.55-2.17) and non-CV death (HR 1.59; 95% CI 1.23-2.05) after full adjustment compared with those in the lowest quartile (<10.1 pg/mL). Hs-cTnI was identified as the strongest predictor for MACEs, CV death, and all-cause death, but not for non-CV death.Baseline hs-cTnI is a strong and independent predictor for MACEs and death in patients with ESKD undergoing haemodialysis.
Item Description:Online veröffentlicht: 11. Februar 2025
Gesehen am 01.07.2025
Physical Description:Online Resource
ISSN:2048-8513
DOI:10.1093/ckj/sfaf047

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