Troponin I Is a Predictor of Acute Cardiac Events in the Immediate Postoperative Renal Transplant Period

Background. Patients on the renal transplant waiting list and renal transplant recipients have an increased risk of premature cardiovascular (CV) disease and death. Methods. We performed a prospective observational study in 331 kidney or kidney-pancreas transplant recipients to test whether Troponin I (TnI), determined at time of engraftment, can help to identify patients at risk for a major adverse cardiac event (MACE) in the immediate postoperative period. Logistic regression analysis was used to test if pretransplant TnI is a predictor of MACE within 3 months after transplantation. Results. Eleven patients (3.3%) developed a MACE during the first 2 weeks after transplantation. In patients with a CV history (23.6%), the incidence of MACE increased to 13.4%. In univariate analysis, age (odds ratio [OR] 1.062, P=0.04), TnI (OR 1.12, P=0.0042), HbAlc (OR 1,879, P=0.0076), and CV history (absent vs. present OR 0.027, P=0.0006) were associated with MACE. TnI remained an independent predictor after adjusting for every other significant variable. When we restricted the analysis to patients with a CV history, TnI was the only statistically significant variable associated with MACE. Conclusion. Elevated TnI, immediately pretransplant, is an independent predictor of MACE in the immediate posttransplant period, particularly in patients with CV history.