{
  "abstract": "Background False cardiac troponin (cTn) elevations from non-cardiac causes are a major concern. We aimed to assess terminal renal failure as a possible non-cardiac cause of elevated high-sensitivity cTnT (hs-cTnT) concentrations using renal transplantation as an in vivo model of rapid restoration of renal function.Methods We analysed consecutive patients with end-stage renal disease (ESRD) undergoing renal transplantation at a single centre. Patients with perioperative myocardial infarction or injury were excluded. Changes in hs-cTnT and creatinine were measured pretransplant and at four post-transplant intervals (day 1, days 2–5 and days 14–180). A decrease of ≥25% in hs-cTnT within 24 hours post-transplant was deemed evidence of renal clearance recovery.Results Among 45 patients (median age 67 years, 31% women), the median pretransplant plasma creatinine concentration was 608 μmol/L (IQR 482–830), and fell to 425 μmol/L (IQR 337–619) on day 1, 289 μmol/L (IQR 201–492) on days 2–5 and 126 μmol/L (IQR 103–191) on days 14–180 (p<0.001, p<0.001 and p=0.003, respectively). The median pretransplant hs-cTnT concentration was 48 ng/L (IQR 34–70). It fell to 26 ng/L (IQR 15–38; geometric mean of relative change 36%) on day 1 (p<0.001) and then remained constant on days 2–5 (26 ng/L (IQR 18–35)) and days 14–180 (25 ng/L (IQR 20–30), p=ns).Conclusion Terminal renal failure is a non-cardiac cause of elevated circulating hs-cTnT concentrations, contributing more than one-third in this cohort, while the remaining two-thirds seem related to chronic cardiomyocyte injury.",
  "authors": [
    {
      "affiliations": [
        "Cardiovascular Research Insitute Basel (CRIB) and Department of Cardiology, University Hospital Basel, Basel, Switzerland, Basel, Switzerland",
        "University Hospital Basel Division of Medicine, Basel, Switzerland"
      ],
      "name": "Androniki Papachristou"
    },
    {
      "affiliations": [
        "Cardiovascular Research Insitute Basel (CRIB) and Department of Cardiology, University Hospital Basel, Basel, Switzerland, Basel, Switzerland"
      ],
      "name": "Christian Puelacher"
    },
    {
      "affiliations": [
        "Cardiovascular Research Insitute Basel (CRIB) and Department of Cardiology, University Hospital Basel, Basel, Switzerland, Basel, Switzerland"
      ],
      "name": "Noemi Glarner"
    },
    {
      "affiliations": [
        "Cardiovascular Research Insitute Basel (CRIB) and Department of Cardiology, University Hospital Basel, Basel, Switzerland, Basel, Switzerland"
      ],
      "name": "Ivo Strebel"
    },
    {
      "affiliations": [
        "Cardiovascular Research Insitute Basel (CRIB) and Department of Cardiology, University Hospital Basel, Basel, Switzerland, Basel, Switzerland",
        "University Hospital Basel Division of Medicine, Basel, Switzerland"
      ],
      "name": "Ibrahim Schaefer"
    },
    {
      "affiliations": [
        "Cardiovascular Research Insitute Basel (CRIB) and Department of Cardiology, University Hospital Basel, Basel, Switzerland, Basel, Switzerland"
      ],
      "name": "Georgiana Virant"
    },
    {
      "affiliations": [
        "University Hospital Basel Department of Transplantation Immunology and Nephrology, Basel, Switzerland"
      ],
      "name": "Juerg Steiger"
    },
    {
      "affiliations": [
        "Cardiovascular Research Insitute Basel (CRIB) and Department of Cardiology, University Hospital Basel, Basel, Switzerland, Basel, Switzerland",
        "University Hospital Basel Department of Transplantation Immunology and Nephrology, Basel, Switzerland"
      ],
      "name": "Matthias Diebold"
    },
    {
      "affiliations": [
        "Department of Anaesthesiology, University Hospital Duesseldorf, Duesseldorf, Germany"
      ],
      "name": "Giovanna LuratiBuse"
    },
    {
      "affiliations": [
        "University Hospital Basel Department of Anaesthetics, Basel, Switzerland"
      ],
      "name": "Daniel Bolliger"
    },
    {
      "affiliations": [
        "University Hospital Basel Department of Anaesthetics, Basel, Switzerland",
        "Department of Clinical Research, University Hospital Basel, Basel, Switzerland"
      ],
      "name": "Luzius Steiner"
    },
    {
      "affiliations": [
        "Department of Vascular Surgery and Renal Transplantation, University Hospital Basel, Basel, Switzerland"
      ],
      "name": "Lorenz Guerke"
    },
    {
      "affiliations": [
        "Department of Vascular Surgery and Renal Transplantation, University Hospital Basel, Basel, Switzerland"
      ],
      "name": "Thomas Wolff"
    },
    {
      "affiliations": [
        "Department of Vascular Surgery and Renal Transplantation, University Hospital Basel, Basel, Switzerland"
      ],
      "name": "Edin Mujagic"
    },
    {
      "affiliations": [
        "Cardiovascular Research Insitute Basel (CRIB) and Department of Cardiology, University Hospital Basel, Basel, Switzerland, Basel, Switzerland"
      ],
      "name": "Danielle Menosi Gualandro"
    },
    {
      "affiliations": [
        "Cardiovascular Research Insitute Basel (CRIB) and Department of Cardiology, University Hospital Basel, Basel, Switzerland, Basel, Switzerland"
      ],
      "name": "Christian Müller"
    },
    {
      "affiliations": [
        "Cardiovascular Research Insitute Basel (CRIB) and Department of Cardiology, University Hospital Basel, Basel, Switzerland, Basel, Switzerland",
        "University Hospital Basel Division of Medicine, Basel, Switzerland"
      ],
      "name": "Tobias Breidthardt"
    }
  ],
  "title": "Terminal renal failure as a contributor to high-sensitivity cardiac troponin T elevations: insights from patients undergoing renal transplantation",
  "uid": "642a4b88-44aa-5775-9474-03bbc594807b"
}