Title : Correlation of troponin and homocysteine levels with coronary artery disease in patients on hemodialysis - A preliminary study
Abstract:
Background and Aims: The aim of this study is to investigate the association of troponin and homocysteine levels with coronary artery disease and the cardiovascular risk in patients with end stage kidney disease (ESKD).
Methods: 50 patients on HD > 6 months (mean duration 31 months), 30 males (60%) and 20 females (40%) with mean age 67.6 years ± 13,21 were included. The patients were divided into two groups based on the presence or absence of coronary artery disease (CAD). Serum troponin and homocysteine levels were correlated with normal laboratory values and among themselves.
Results: Troponin levels were found elevated in 36% and homocysteine in 78% of patients. There was a positive correlation between troponin and age (spearmans rho 0.27, p=0.04) while elevated homocysteine levels did not appear to be related to the age of the patients (p=0.6). A positive correlation between homocysteine and troponin levels (p=0.006) was observed in both patients with and without CAD. In addition, the change in homocysteine was positively related to the change in troponin levels (p=0.02, r=0.32). The frequency of pathological troponin levels was significantly higher in women than in men (chi-square, p<0.001). Additionally, troponin levels were higher in patients with CAD (p=0.007) while homocysteine levels were higher in patients without CAD (p=0.04).
Conclusions: Troponin appears to correlate positively with homocysteine in both patients with and without CAD. Patients with CAD have elevated troponin levels while quaintly patients without CAD have elevated homocysteine levels. Men appear to have a lower risk of abnormal troponin levels than women. Further analyses with more patients will take place in order to confirm or not our preliminary findings.
