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The Prognosis Value of Troponin T for
Ischemic Events in Diabetic Patients with
Chronic Renal Insufficiency Varies
According to its Functional Grade.
Bono, Julio; Aguiar Muñoz, Sebastián;
Novoa, Pablo; De Elías, Rafael; Kiener, Oscar
Nephrology Department of Allende Clinic
and Cordoba Hospital,
Coronary Unit and Central Laboratory of Allende Clinic, Córdoba, Argentina
Introduction: The prognosis value of Troponin T (TNT) in patients with chronic renal insufficiency undergoing dialysis (CRID) varies according to the publications, but there is not much literature on patients with chronic renal insufficiency without dialysis (CRIwD).
Objective: To determine the prognosis value of TNT for Ischemic Events (IE) to 6 months in patients CRID with diabetes nephropathy ( CRID- D) , without diabetes nephropathy ( CRID-ND ) and in patients with diabetes nephropathy with CRI but before being admitted to dialysis treatment (CRIwD-D).
Material and Method: It is a prospective study in a group of 20 patients with CRID-D, 56 patients with CRID-ND and 25 patients CRIwD-D. TNT basal was determined and the patients were classified in two groups: Positive TNT (PT) to > 0.05ng/ml values and negative TNT (NT) to lower values. The IE (to 6 months follow-up)considered were: pump failure, death, acute MI and refractory angina. The absolute values of TNT were considered in median and intercuartilic range (RI).
Results: TNT values: 0.06ng/ml (RI 0.03-0.14) in patients CRID-D; 0.01ng/ml (0.01-0.03) in CRID-ND and 0.01ng/ml (0.01-0.04) in CRIDwD-D; with a significative difference between CRID-D and CRIwD-D (P< 0.005) and not significant between CRID-ND and CRIDwD-D (P=0.81). The PT frequency was significantly higher in CRID-D than in CRID-ND and CRIDwD-D ( 55% versus 21.4% versus 20% respectively, P<0.01). The incidence of IE in 6 months of follow-up, it does not differ among the three groups ( 15% versus 5.4% versus 8% respectively, P= 0.39). In CRIDwD-D, 40% of PT patients versus 0% NT patients had IE within 6 months ( P<0.05)
Conclusion: 1. TNT in patients with CRID does not show prognosis usefulness for IE, either in D or ND. 2. The TNT allows to identify patients CRIDwD-D with a high risk of suffering IE within 6 months.
2nd Virtual Congress of Cardiology
Dr. Florencio Garófalo
Dr. Raúl Bretal
Dr. Armando Pacher
Technical Committee - CETIFAC
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