Hypersensitivity TroponinⅠ Levels in Maintenance Hemodialysis Patients and Their Relationship with All-Cause Mortality

WANG Di; WANG Qi; QIN Wentao

doi:10.3639/i.issn.2095-3097.2024.10.014

Abstract：Objective To investigate the level of hypersensitive troponinⅠ(hs-cTnⅠ)in maintenance hemodialysis patients and its relationship with all-cause mortality.Methods A total of 177 maintenance hemodialysis patients admitted to our hospital from January 2018 to March 2021 were selected.According to the different quartiles of baseline hs-cTnⅠlevels,they were divided into Q1 group(n=43),Q2 group(n=45),Q3 group(n=42),and Q4 group(n=47).The differences in baseline data among the four groups were analyzed.All patients were followed up for 2 years to collect mortality information,logistic regression and Cox proportional hazards regression was used to analyze the relationship between baseline hs-cTnⅠ and all-cause mortality.Results The proportion of diabetes history,platelet count,BNP,CRP,PCT,and iPTH in the four groups showed statistically significant differences(P＜0.05).The average baseline hs-cTnⅠ level of deceased cases was higher than that of non-deceased cases[(131.62±7.85)ng/mL vs.(81.49±5.11)ng/mol,P＜0.05].The proportion of all-cause deaths in the Q4 group was higher than in the Q1,Q2,and Q3 groups(P＜0.05).Kaplan-Meier analysis showed that the survival rate in the Q4 group was lower than that in the Q1,Q2,and Q3 groups(Log-rank x2=8.672,7.112,7.064,P＜0.05).Logistic regression analysis indicated that patients with baseline hs-cTnⅠ＞117.15 ng/mL had the highest incidence of all-cause mortality(HR=3.572,95％CI=2.035-6.268).The results of multivariate Cox proportional hazards regression analysis showed that patients with baseline hs-cTnⅠ＞117.15 ng/mL had an increased risk of all-cause mortality(HR=3.117,95％CI=1.567-6.203)compared to those with baseline hs-cTnⅠ＜63.72 ng/mL.After adjusting for age,gender,and biochemical indicators,the all-cause mortality risk ratio for patients with baseline hs-cTnⅠ＞117.15 ng/mL was 2.643(95％CI=1.328-5.259).Conclusion Baseline hs-cTnⅠ levels in maintenance hemodialysis patients are closely related to all-cause mortality,and an increase in its level may increase the risk of all-cause mortality in these patients.