Abstract
Objectives
The relationship between high-sensitive cardiac troponin T concentration (hs-cTnT) and renal markers levels is known. However, the extent to which their variations are associated remains to be explored. Objective: model the relationship between relative changes in hs-cTnT (Δhs-cTnT) and variations in creatinine (Δcre) or estimated glomerular filtration rate (ΔeGFR), using a quantile generalized additive model (qgam).
Methods
Concomitant plasma Δhs-cTnT and Δcre from patients aged 18–100 years, selected with a time variation (Δtime) of 3 h–7 days, were collected over a 5.8-year period. Relationships between Δhs-cTnT and covariates Δcre (A) or ΔeGFR (B), including age, Δtime, hour of blood sampling (HSB) and covariates interactions were fitted using qgam.
Results
On the whole (n=106567), Δhs-cTnT was mainly associated with Δcre, in a positive and nonlinear way (−21, −6, +5, +20, +55% for −50, −20, +20, +50, +100%, respectively), but to a lesser extent with age (min −9%, max +2%), Δtime (min −4%, max +8%), and HSB (min −5%, max +7%). Δhs-cTnT was negatively associated with ΔeGFR (+46, +7, −5, −11, −20% for −50, −20, +20, +50, +100%, respectively). Classifying Δhs-cTnT as consistent or not with myocardial injury based on recommendations, an interpretation of Δhs-cTnT adjusted for model A or B led to statistically significant but small diagnostic discrepancies (<2%), as compared to an interpretation based on Δhs-cTnT only.
Conclusions
From a laboratory and statistical standpoint, considering renal function variations when interpreting relative changes in cardiac troponin T has a minor impact on the diagnosis rate of myocardial injury.
Acknowledgments
The authors are grateful to Vincent Fitzpatrick for his English proofreading.
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Research funding: None declared.
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Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
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Competing interests: Authors state no conflict of interest.
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Supplementary Material
The online version of this article offers supplementary material (https://doi.org/10.1515/cclm-2020-0820).
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