Effect of Hemodialysis, Coronary Artery Disease and Diabetes on Cardiac Troponin T: A Prospective Survey Over One Year

BACKGROUND Limited data is available about the effects of hemodialysis sessions, coronary artery disease (CAD), and diabetes on serum cardiac troponin T (cTnT) levels in patients with end-stage renal disease (ESRD). OBJECTIVES To test whether hemodialysis could be associated with an increase in cTnT concentration. To evaluate if coronary artery disease (CAD) or diabetes are associated with higher cTnT levels in ESRD. METHODS Serum cTnT levels were measured immediately before and after dialysis 3 times over 1 year (0, 6, and 12 months). RESULTS A total of 100 ESRD patients without acute coronary syndrome (mean age of 58.5 years, 34% with diabetes, and 37% with CAD) gave 267 pre-dialysis and 260 post-dialysis blood samples. The mean (standard deviation) pre-dialysis cTnT levels were 0.06 (0.12), 0.05 (0.06), and 0.07 (0.07) mcg/L at 0, 6, and 12 months, respectively. The post-dialysis cTnT levels were similar on average. Among 259 samples with cTnT measured both before and after dialysis, 79 (30.5%) showed a decrease in serum cTnT, 97 (37.5%) showed an increase and 83 (32%) showed no change following dialysis. Mean cTnT was higher in CAD than in non-CAD patients. We observed no significant difference in mean cTnT levels between diabetic and non-diabetic patients. CONCLUSIONS cTnT levels were not affected by individual hemodialysis sessions, and remained stable around 0.06 mcg/L over a 1-year period in ESRD patients. Random cTnT levels were higher in stable CAD patients undergoing hemodialysis.