Nesrine Amdouni1, Ikram Chamtouri1, Asma Ben Abdallah1, Walid Jomaa1, Khaldoun Ben Hamda1, Faouzi Maatouk1
1CHU FAttouma Bourguiba Monastir, Monastir, Tunisia
Chronic kidney disease (CKD) including chronic hemodialysis (CHD) is closely associated with higher risk of cardiovascular disease, and the presence of CKD is a potential predictor of a worse prognosis among patients with coronary artery disease.
The aim of this study is to evaluate the relation between levels of troponin T (TnT) and the risk of severe ischemic disease in patients on CHD.
Patients on CHD presenting with ischemic symptoms and hospitalizes in the cardiology department of Fattouma Bourguiba University Hospital between January 2014 and March 2018 were enrolled in this retrospective study (n=71). Their levels of TnT were analized at admission. the main outcome of interest was the severity of coronary artery lesions identified on coronarography. The secondary outcomes included decreased left ventricular ejection fraction (LVEF <40%) and presence of left ventricular hypertrophy (LVH).
out of overall CHD patients, 51 presented severe lesions (71.8%) with 47.9% of one vessel coronary artery disease. The rest of patients had wether normal coronary angiography (11.3%) or atheromatous infiltration without significant stenosis (16.9%). A direct relationship was seen between increased level of TnT and risk of severe coronary lesions (p=0.003). Whereas, compared to patients with low TnT, those with high levels of this marker had not higher risk of 2 or 3 vessel coronary disease. Severe decreasedLVEF was observed among only 8% of patients and LVH was noted in 55% of cases. There was no association between levels of TnT and LVH or reduced LFEF.
TnT levels seems to be good predictor of severe coronary disease and long term follow-up is needed to determine if there is a relation with the risk of mortality after adjusting for a number of potential confounders.