Kidney Week

Abstract: TH-PO446

The Association between Cardiac Troponin T and Coronary Artery Calcification in CKD: Result from the Korean Cohort Study for Outcomes in Patients with CKD

Session Information

• CKD: Epidemiology, Outcomes - Cardiovascular - I
  November 02, 2017 | Location: Hall H, Morial Convention Center
  Abstract Time: 10:00 AM - 10:00 AM

Category: Chronic Kidney Disease (Non-Dialysis)

• 303 CKD: Epidemiology, Outcomes - Cardiovascular

Authors

• Kang, Eunjeong, Seoul National University Hospital, JongNo-Gu, SEOUL, Korea (the Republic of)

Eunjeong Kang,

• Kim, Hyo Jin, Dongguk University Gyeongju Hospital, Gyeongju, Korea (the Republic of)

Hyo Jin Kim,

• Ryu, Hyunjin, Seoul National University Hospital, JongNo-Gu, SEOUL, Korea (the Republic of)

Hyunjin Ryu,

• Han, Miyeun, Busan National University Hospital, Busan, Korea (the Republic of)

Miyeun Han,

• Kim, Hyun suk, Chuncheon Sacred Heart Hospital, Chuncheon, Korea (the Republic of)

Hyun suk Kim,

• Ahn, Curie, Seoul National University Hospital, JongNo-Gu, SEOUL, Korea (the Republic of)

Curie Ahn,

• Oh, Kook-Hwan, Seoul National University Hospital, JongNo-Gu, SEOUL, Korea (the Republic of)

Kook-Hwan Oh,

Background

Although cardiac troponin T (cTnT) is one of the biomarkers for the diagnosis of acute coronary syndromes, the association between cTnT and coronary artery calcification (CAC) in chronic kidney disease (CKD) patients are less well known, especially in Asian population.

Methods

We conducted a cross-sectional study and data were collected from the KNOW-CKD cohort. cTnT was measured by the highly sensitive assay and were categorized into 4 groups by quartiles (≤6.0, >6.0-10.0, >10.0-16.0, >16.0 pg/mL). CAC was evaluated through Agatston score calculated based on the extent of CAC detected by an electron-beam computed tomography scan. CAC scores were divided into 3 groups: 0-100, >100-400, and >400. We conducted multinomial logistic regression to evaluate the relationship between cTnT and CAC. Age, sex, CKD stage, diabetes, body mass index, hemoglobin, low density lipoprotein, and high density lipoprotein were included as covariates. We carried out subgroup analysis which divided into 2 groups based on estimated glomerular filtration rate (eGFR) 60mL/min/1.73m².

Results

Total 2,061 patients were included. The mean age was 53.5±12.3 years; 61.0% of patients were men, 5.3 % were diabetic and 1.4% were had history of myocardial infarction. CAC score was 183.2±523.1. After multivariable adjustments, compared to the lowest cTnT group, the highest cTnT group tended to have higher CACS in a fully adjusted multivariable model (CACS >100-400, odds ratio [OR] 2.460, 95% confidential interval [CI] 0.920-6.574, P=0.073; CACS >400, OR 10.175, 95% CI 2.076-49.878, P=0.004; reference group CACS 0-100). In a subgroup analysis according to eGFR, statistical significance was weakened in lower eGFR group with full adjustment. In receiver operating curve analysis, area under the curve was above 0.8, regardless of the eGFR subgroup.

Conclusion

Elevated concentration of cTnT was independently associated with the degree of severity of CAC in the CKD population of Korea. In subgroup analysis according to eGFR, the statistical significance regarding coronary artery calcification was weakened in lower eGFR group. Circulating cTnT levels is a fair screening test for the detection of coronary artery calcification in a subgroup with eGFR over 60 mL/min/1.73m².

Funding

• Government Support - Non-U.S.