***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Abstract —End-stage renal disease patients experience a high incidence of sudden cardiac death . We performed a 5-year prospect i ve study in 230 end-stage renal disease patients , aim ing to determine the role of echocardiography and the additional value of serum biomarkers in predicting sudden cardiac death . During follow-up , 24 % of all deaths were attributed to sudden cardiac death . In the multivariable Cox regression analysis considering clinical , biochemical , dialysis , and echocardiographic parameters , left ventricular systolic dysfunction emerged as the most significant predictor of sudden cardiac death , followed by a high systolic and a low diastolic blood pressure . An ejection fraction cutoff ≤48.0 % is associated with a specificity of 78.6 % and a sensitivity of 57.7 % in predicting sudden cardiac death . In biomarker-based multivariable Cox regression analysis , N-terminal probrain natriuretic peptide displays an independent association with sudden cardiac death and is more significantly associated with sudden cardiac death than cardiac troponin T. In the combined echocardiography and biomarker-based multivariable Cox regression model , N-terminal probrain natriuretic peptide loses significance to left ventricular ejection fraction , whereas cardiac troponin T retains a significant association with sudden cardiac death independent of echocardiographic parameters . In conclusion , systolic dysfunction is the most significant predictor of sudden cardiac death followed by a high systolic and a low diastolic blood pressure . Our data suggest additional value in measuring cardiac troponin T for sudden cardiac death risk stratification . N-terminal probrain natriuretic peptide may be used in place of echocardiography to identify patients at risk of sudden cardiac death but had no added value over echocardiography in predicting sudden cardiac death BACKGROUND We investigated whether cardiac troponin T ( cTnT ) independently predicted outcome and added prognostic value over other clinical risk predictors in chronic peritoneal dialysis ( PD ) with end-stage renal disease . METHODS Baseline cTnT , echocardiography , indices of dialysis adequacy , and biochemical characteristics  were assessed in 238 chronic PD patients who were followed prospect ively for 3 years or until death . RESULTS Using multivariable Cox regression analysis , cTnT remained predictive of all-cause mortality [ hazard ratio 4.43 , 95 % CI 1.87 - 10.45 , P = 0.001 ] , cardiovascular death ( 4.12 , 1.29 - 13.17 , P = 0.017 ) , noncardiovascular death ( 8.06 , 1.86 - 35.03 , P = 0.005 ) , and fatal and nonfatal cardiovascular events ( CVEs ) ( 3.59 , 1.48 - 8.70 , P = 0.005 ) independent of background coronary artery disease , inflammation , residual renal function , left ventricular hypertrophy , and systolic dysfunction . cTnT alone had better predictive value than C-reactive protein ( CRP ) alone for mortality [ area under the ROC curve ( AUC ) 0.774 vs 0.691 ; P = 0.089 ] and first CVE ( AUC 0.711 vs 0.593 ; P = 0.009 ) at 3 years . Survival models including age , sex , and clinical , biochemical , and echocardiographic characteristics yielded AUCs of 0.813 ( 95 % CI , 0.748 - 0.877 ) , 0.800 ( 95 % CI , 0.726 - 0.874 ) , and 0.769 ( 95 % CI , 0.708 - 0.830 ) , respectively , in relation to all-cause mortality , cardiovascular death , and fatal and nonfatal cardiovascular events . After addition of cTnT , AUCs of the above models increased significantly to 0.832 ( 95 % CI , 0.669 - 0.894 ; P = 0.0037 ) , 0.810 ( 95 % CI , 0.739 - 0.883 ; P = 0.0036 ) , and 0.780 ( 95 % CI , 0.720 - 0.840 ; P = 0.0002 ) , respectively ; no AUCs increased when CRP was added . CONCLUSIONS cTnT is an independent predictor of long-term mortality , cardiovascular death and events , and noncardiovascular death in PD patients BACKGROUND Cardiac biomarkers are emerging as a potentially powerful prognostic tool for renal-dialysis patients . The optimal biomarker and /or combination of biomarkers for predicting mortality remain uncertain . This study evaluates the prognostic value of the new high-sensitivity troponin T ( TnT ) assay compared to established biomarkers . METHODS All patients had blood sample d  for prospect i ve assessment of the prognostic value of traditional risk markers including albumin and CRP , and cardiac biomarkers BNP , NT-proBNP , TnT and TnI. Patients were closely monitored clinical ly . Mortality and morbidity outcomes were documented for a national morbidity and mortality data base . Stored sample s were subsequently used to measure TnT  with a new high-sensitivity assay . RESULTS After a median of 30 months from blood collection , NT-proBNP was the most powerful predictor of all-cause mortality , along with albumin . After a median of 46.7 months the new high-sensitive TnT assay was the only cardiac biomarker predictive of all-cause mortality . TnT was detectable in all dialysis patients using the high-sensitive TnT assay with a cut-point of 24.15 ng/L below which all patients survived . CONCLUSIONS The new hs-TnT is the most powerful biomarker for prognostic classification for all-cause mortality of all the commonly used biomarkers for our renal-dialysis population . Our study also suggests that cardiac biomarkers have a different prognostic ability for different time frames with NT-proBNP being a better predictor for early mortality and troponin for later mortality BACKGROUND Cardiac troponin T ( cTnT ) is a highly sensitive and specific marker of myocardial damage . In sera from patients with end-stage renal disease , cTnT may be elevated without other signs of acute myocardial injury . It has been shown that elevated cTnT in haemodialysis patients is associated with poor prognostic outcome . The aim of the present study was to test the hypothesis that elevated cTnT in a single serum sample from peritoneal dialysis ( PD ) patients is of prognostic importance . METHODS Blood sample s were taken from 26 r and omly selected PD patients without signs of acute myocardial ischaemia . Sera were analysed for : cTnT with the second generation TnT ELISA on ES 300 ; cardiac troponin I ( cTnI ) with Opus Plus ; and for creatine kinase-MB ( CKMB ) mass and C-reactive protein ( CRP ) . After 4 years , clinical outcomes were evaluated by chart review . The influence on survival was tested with Kaplan-Meier analysis and Cox 's proportional regression analysis . RESULTS Concentrations of cTnT > /=0.04 micro g/l and CRP > /=10 mg/l were strong predictors of all-cause mortality in univariate analysis . Twelve out of 14 patients with cTnT > /=0.04 micro g/l died compared with three out of 12 with cTnT < 0.04 micro g/l . Other factors that influenced survival were age and the presence of ischaemic heart disease ( IHD ) . There was a significant positive correlation between cTnT and CRP , and between cTnT and age . Cardiac troponin T was an independent predictor compared with age but not compared with CRP and IHD . Neither cTnI nor CKMB mass concentrations were related to survival . CONCLUSION Elevated serum concentrations of cTnT significantly predicted poor outcome and there was a correlation between cTnT and CRP concentrations in sample s from PD patients . Cardiac troponin I and CKMB mass had no prognostic value Background : Recent studies revealed that elevated cardiac troponin T ( cTnT ) could predict all-cause mortality and cardiovascular diseases in end-stage renal disease patients . This study aim ed to evaluate cTnT as a prognostic value in asymptomatic continuous ambulatory peritoneal dialysis patients . Methods : This is a prospect i ve observational study with 107 prevalent peritoneal dialysis patients . cTnT , high-sensitive C-reactive protein ( hsCRP ) and IL-6 were measured at baseline . Based on cTnT level , patients were classified as higher cTnT group ( HT , n = 21 , cTnT ≥0.1 ng/ml ) and lower cTnT group ( LT , n = 86 , cTnT < 0.1 ng/ml ) , and were followed for 3 years . Primary endpoint was cardiovascular events . Results : The HT group had a significantly higher level of log hsCRP and log IL-6 than the LT group ( p < 0.05 ) . Kaplan-Meier survival demonstrated worse cardiovascular event-free survival for the HT group . Multivariate analysis adjusted for age , cTnT , IL-6 and hsCRP level revealed that age ( per 1-year increase , HR 1.07 , p < 0.05 ) , elevated cTnT ( vs. < 0.1 ng/ml , HR 5.89 , p < 0.05 ) and hsCRP ( vs. < 3.0 mg/l , HR 4.15 , p < 0.05 ) were identified as significant determinants of cardiovascular events . Conclusion : This study suggests that cTnT may be an aid in risk stratification of continuous ambulatory peritoneal dialysis patients Background : The relationship of routine postoperative troponin I ( TnI ) monitoring in kidney transplant recipients and in-hospital myocardial infa rct ion ( MI ) is not known . Methods : This observational study evaluated the prevalence of  abnormal postoperative TnI ( Ortho Clinical Diagnostics assay ) in 376 consecutive kidney or kidney/pancreas transplant recipients . In-hospital MI was adjudicated using the universal definition . Rates of death and coronary revascularizations at 1 year were studied . Logistic regression analysis was performed to identify independent predictors of abnormal TnI. Results : Ninety-five ( 25 % ) recipients had abnormal TnI ( > 0.04 ng/ml ) following transplantation . Abnormal TnI levels were more common in older ( mean age : 52.2 ± 13.4 vs. 48.3 ± 13.2 years , p = 0.01 ) , diabetic ( 57.9 vs. 45.6 % , p = 0.04 ) , and prior coronary artery disease ( 31.6 vs. 20.3 % , p = 0.02 ) patients . In-hospital MI occurred in 6 patients ( 1.6 % ) . All subsequent in-hospital cardiovascular events occurred in the abnormal postoperative TnI group ; most in those with TnI levels > 1 ng/ml . Previous coronary artery disease was the only independent predictor of a postoperative TnI level > 1 ng/ml in multivariate analysis ( odds ratio 4.61 , 95 % confidence interval 1.49–14.32 ) . At 1 year there was no significant difference in death ( 3.2 vs. 1.8 % , p = 0.42 ) and borderline significant difference in coronary revascularization ( 5.3 vs. 1.4 % , p = 0.049 ) in abnormal versus normal TnI groups . Conclusions : In-hospital MI was infrequent , but abnormal TnI highly prevalent following renal transplantation . Normal TnI levels following renal transplantation had a high negative predictive value in excluding patients likely to develop subsequent postoperative MI . The role of a higher TnI cut-off for screening for postoperative MI in high-risk subgroups deserves future prospect i ve evaluation BACKGROUND Cardiac troponin T ( cTnT ) is a subunit of the cardiac actin-myosin complex , which leaks into the circulation when myocardial necrosis is present . Detection of cTnT is associated with a poor outcome in patients with unstable angina , and is a useful tool for risk stratification . The value of cTnT determination in patients with renal failure has been question ed , and the specificity of cTnT in this particular group has not been established . METHODS In the present study , 94 patients at a single centre were followed prospect ively after three determinations of cTNT , at 1-month intervals . The outcome after 12 months was chosen as the end-point . cTnT was measured using both a quantitative chemiluminiscence immunoassay and a qualitative rapid bedside immunoassay on a test strip . The maximum of three measurements was used and was correlated with different parameters and outcome . The following statistical tests were performed : Kaplan-Meier analysis , Cox 's proportional regression analysis for measuring survival and logistic regression for analysing factors influencing 
    Output:
    
Among patients receiving dialysis , an elevated troponin level was associated with a higher risk ( approximately 2- to 4-fold ) for all-cause mortality , cardiovascular mortality , and MACE .