Troponin T is an independent predictor of mortality in renal transplant recipients

Background. Numerous reports have demonstrated an association between elevated Troponin T levels and adverse cardiovascular outcomes in patients with chronic kidney disease. However, whether raised Troponin T levels are an independent predictor of mortality in renal transplant recipients has not yet been established. The aim of this study was, therefore, to assess the use of Troponin T as a prognostic marker in a population of renal transplant recipients. Methods. Three hundred and seventy-two asymptomatic renal transplant recipients were recruited between June 2000 and December 2002. Troponin T was measured at baseline and prospective follow-up data were collected at a median of 1739 days. Results. In Kaplan-Meier analysis a Troponin T level >= 0.03 mu g/l was a significant predictor of mortality (P < 0.001). In Cox Regression analysis, an elevated Troponin T level remained a significant predictor of mortality following adjustment for traditional cardiovascular risk factors (P < 0.001) and following adjustment for estimated glomerular filtration rate and high sensitivity C reactive protein (P < 0.001). Conclusions. Elevated Troponin T level is a strong independent predictor of all cause mortality in patients with a renal transplant. Troponin T, therefore, represents a promising biochemical marker that identifies those renal transplant recipients who are most likely to benefit from aggressive cardiovascular risk factor modification.