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The following is a summary of “Prognostic Implications Of High-Sensitivity Cardiac Troponins In Patients With Acute Kidney Injury Without Myocardial Infarction,” published in the May 2025 issue of American Journal of Cardiology by Cyon et al. 

Elevated and fluctuating high-sensitivity cardiac troponin T (hs-cTnT) levels were frequently observed in individuals with acute kidney injury (AKI) without myocardial infarction (MI), though their prognostic significance remained unclear.  

Researchers conducted a retrospective study to examine the relationship between hs-cTnT levels and outcomes in individuals with AKI in the emergency department (ED).  

They included all initial visits to 7 EDs from 2010 to 2017 involving individuals without MI who met AKI criteria and had at least 1 hs-cTnT measurement. Peak hs-cTnT levels and relative changes in hs-cTnT (Δhs-cTnT) were analyzed. Logistic regression assessed short-term risks, and Cox regression evaluated long-term risks of mortality and major adverse cardiovascular events (MACE).  

The results showed that 12,136 individuals were included. In-hospital mortality was 15%, and long-term mortality reached 49% [median follow-up: 3.8 years; interquartile range (IQR): 1.3–6.0]. Adjusted in-hospital mortality rose with increasing peak hs-cTnT levels, exceeding an 8-fold risk in the highest quintile [aOR: 8.68, 95% CI: 6.85–11.0]. Long-term cardiovascular mortality and MACE risks were also elevated in this group [hazard ratio (HR): 3.01, 95% CI: 2.74–3.31 and HR: 2.12, 95% CI: 2.00–2.24, respectively]. These risks were observed even with intermediate hs-cTnT elevations and in individuals with transient AKI or normalized estimated glomerular filtration rate (eGFR) at discharge. Higher Δhs-cTnT was linked to increased short-term mortality but showed no association with long-term mortality and only a weak link to MACE.  

Investigators concluded that peak hs-cTnT levels were linked to poorer short- and long-term outcomes in individuals with acute kidney injury without MI, while dynamic changes had limited prognostic value in the field of nephrology. 

Source: ajconline.org/article/S0002-9149(25)00329-7/fulltext