#6677 RELATIONSHIP BETWEEN CARDIAC TROPONIN LEVELS AND ECHOCARDIOGRAPHIC PARAMETERS IN DIABETICS WITH ADVANCED CHRONIC RENAL DISEASE (ACKD)

Abstract

Background and Aims: Cardiovascular disease is the leading cause of chronic kidney disease (CKD) death. On the other hand, elevated cardiac Troponin T (cTnT) levels are associated with cardiovascular events and mortality. Several studies have established an inverse association between CKD and cTnT, and knowledge of this association in diabetic patients would benefit their management. The objective of this study was to analyze the relationship between cTnT levels, renal function and echocardiographic parameters in diabetic patients with advanced chronic kidney disease (ACKD). Method: A prospective study was carried out during one year of 180 patients attending for the first time for ACKD consultations, with an estimated glomerular filtration rate (eGFR) <30 ml/min/1.72 m2. The following data were analyzed: age, sex, diabetes, HBP, BMI, smoking, peripheral artery disease, coronary artery disease, non-age-adjusted Charlson index (non-age-CCI), eGFR by CKD EPI, ultrasensitive cTnT, Creatinine albumin ratio (ACR), C-reactive protein (CRP), ferritin, hemoglobin (Hb), ejection fraction (EF) and left ventricular hypertrophy (LVH), interventricular septum thickness (IVST) and left ventricular wall thickness (LVWT). Statistical tests were used according to the distribution of the variables. Results: Baseline characteristics are summarized in Table 1. In the group of patients, when analyzing the presence or absence of diabetes, diabetic patients were significantly older, had higher troponin levels, a higher percentage of smoking, coronary artery disease, peripheral artery disease, non-age-CCI, IVST and LVH than non-diabetic patients. In diabetic patients, troponin levels correlated significantly with eGFR (0.03) and ACR (0.09), with ACR remaining as a predictive variable (0.003). It did not correlate with echocardiographic data. In non-diabetics, the correlation was significant with age and IVST and LVH (Table 2, Figure 1). In the multivariate analysis in diabetic patients, only the association remained with ACR (0.026) and in non-diabetics with eGFR (0.038) and IVST (0.004). Conclusion: The cTnT levels are found to be higher in diabetic patients and with higher ACR, considering it as a therapeutic target to reduce cardiovascular risk since echocardiographic data would not discriminate this risk in this profile of patients. (Table Presented).