High-sensitivity cardiac troponin T is associated with acute kidney injury in emergency department patients.

IF 2.2 4区医学 Q3 BIOTECHNOLOGY & APPLIED MICROBIOLOGY

Biomarkers Pub Date : 2026-10-08 DOI:10.1080/1354750X.2026.2742157

Megan Woelkers, Sutton Fox, Davis C Murray, Saiharinath Nerella, Elizabeth Tabornal, Nicholas Bevins, Robert Fitzgerald, Lori B Daniels

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Abstract

Introduction: Chronic high-sensitivity cardiac troponin T (hs-cTnT) elevations are common in chronic kidney disease, but whether hs-cTnT predicts subsequent acute kidney injury (AKI) is unclear.

Methods: We examined the association between maximum hs-cTnT and subsequent AKI in 23,292 Emergency Department encounters. AKI was defined as serum creatinine (sCr) increase ≥0.3 mg/dL within 48 hours or ≥1.5x the presenting value; secondary endpoints were time to AKI and peak sCr.

Results: AKI occurred in 8.9% of encounters. Maximum hs-cTnT was independently associated with AKI (adjusted OR 1.58 [95% CI 1.53-1.63] per 1-unit increase in ln[hs-cTnT]), with similar associations among encounters with and without reduced kidney function at presentation. The median interval from maximum hs-cTnT to AKI was 43 hours (IQR, 21-97). A data-derived hs-cTnT cutoff of 148 ng/L yielded an AUC of 0.82, 80% sensitivity, 70% specificity, and 97% negative predictive value for AKI. Among encounters with AKI, maximum ln(hs-cTnT) was modestly associated with ln(sCr) at AKI in univariable analysis (R²=0.10) and with subsequent maximum ln(sCr) after multivariable adjustment (incremental R²=0.04; both P < 0.0001).

Conclusion: Maximum hs-cTnT identified patients at increased risk for subsequent AKI, including those with normal renal function at presentation, and may help identify patients warranting closer kidney-function monitoring.

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高敏感性心肌肌钙蛋白T与急诊科患者急性肾损伤相关

慢性高敏感性心肌肌钙蛋白T （hs-cTnT）升高在慢性肾脏疾病中很常见，但hs-cTnT是否能预测随后的急性肾损伤（AKI）尚不清楚。方法：我们检查了23,292例急诊科病例中最高hs-cTnT与随后AKI之间的关系。AKI定义为48小时内血清肌酐（sCr）升高≥0.3 mg/dL或≥1.5倍现时值；次要终点为AKI时间和sCr峰值。结果：AKI发生率为8.9%。最大hs-cTnT与AKI独立相关（ln[hs-cTnT]每增加1个单位调整OR为1.58 [95% CI 1.53-1.63]），在出现肾功能下降和未出现肾功能下降的患者中也有类似的关联。从最大hs-cTnT到AKI的中位间隔时间为43小时（IQR, 21-97）。数据导出的hs-cTnT临界值为148 ng/L， AUC为0.82，敏感性80%，特异性70%，AKI阴性预测值为97%。在遭遇AKI的患者中，单变量分析中最大ln（hs-cTnT）与AKI时的ln（sCr）有一定的相关性（R2=0.10），多变量调整后的最大ln（sCr）也有一定的相关性(R2= 0.04；两者均为P。结论：最大hs-cTnT可识别出后续AKI风险增加的患者，包括出现时肾功能正常的患者，并可能有助于识别需要更密切肾功能监测的患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Biomarkers 医学-毒理学

CiteScore

5.00

自引率

3.80%

发文量

140

审稿时长

3 months

期刊介绍： The journal Biomarkers brings together all aspects of the rapidly growing field of biomarker research, encompassing their various uses and applications in one essential source. Biomarkers provides a vital forum for the exchange of ideas and concepts in all areas of biomarker research. High quality papers in four main areas are accepted and manuscripts describing novel biomarkers and their subsequent validation are especially encouraged: • Biomarkers of disease • Biomarkers of exposure • Biomarkers of response • Biomarkers of susceptibility Manuscripts can describe biomarkers measured in humans or other animals in vivo or in vitro. Biomarkers will consider publishing negative data from studies of biomarkers of susceptibility in human populations.