Cardiac troponin levels in patients with impaired renal function

Donaldson, Alison; Cove-Smith, R.

doi:10.12968/hosp.2001.62.2.2093

Cited by 6 publications

(3 citation statements)

References 18 publications

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“…27 It is unlikely that increased serum cTnI is the result of decreased clearance by the failing kidneys. cTnI is cleared by the reticulo‐endothelial system (RES), and renal failure should only have minor effects on RES 27 . Pericarditis secondary to uremia is a well‐documented condition in people affecting the subepicardium leading to the release of cTnI 28 .…”

Section: Discussionmentioning

confidence: 99%

Correlation of Serum Cardiac Troponin I and Myocardial Damage in Cattle with Monensin Toxicosis

Varga

Schober

Holloman

et al. 2009

Veterinary Internal Medicne

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Background: Cardiac troponin I (cTnI) is used as a biomarker of myocardial injury in people and small animals. Little is known about the diagnostic use of cTnI in cattle.Hypothesis: Serum cTnI correlates to myocardial function and histopathologic lesions in cattle with monensin-induced myocardial injury.Animals: Ten healthy cows. Methods: Experimental study. Animals received 1 dose of monensin PO; 30 mg/kg (n 5 1) or 40 mg/kg (n 5 1) (Group A) or 50 mg/kg monensin (n 5 8) (Group B) of body weight. Repeated measurements were performed of serum cTnI, biochemistry, and ECG and echocardiography until study termination at 80 (Group A) and 144 hours (Group B) after dosing. Semiquantitative histopathologic examinations of the heart were performed in each cow. A scoring system with regard to the magnitude of myocardial injury was established and a total heart score was compared with maximum cTnI concentration measured after monensin administration. Five hearts from healthy cows served as controls.Results: Increased cTnI (40.07 ng/mL) was found in 9/10 cows. cTnI was significantly associated with left ventricular shortening fraction (r 2 5 0.51; P 5 .02) and myocardial histopathologic lesion score (r 2 5 0.49; P 5 .021). All cows (n 5 7) with evidence of myocardial necrosis had a cTnI concentration ! 1.04 ng/mL.Conclusion and Clinical Importance: cTnI is related to myocardial necrosis and severity of myocardial damage in cattle with monensin toxicosis. cTnI could become a useful diagnostic tool in the noninvasive assessment of myocardial injury in cattle with naturally occurring cardiac disease.

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Section: Discussionmentioning

confidence: 99%

Correlation of Serum Cardiac Troponin I and Myocardial Damage in Cattle with Monensin Toxicosis

Varga

Schober

Holloman

et al. 2009

Veterinary Internal Medicne

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“…In patients with normal renal function, cTnT levels will increase in the first 3 to 5 hours following myocardial infarction and remain high for up to 21 days, whereas their cTnI levels will increase in the first 3 hours and remain high for up to 7 days. According to recent studies, serum cardiac troponin levels are elevated in at least 50% of patients with renal disease (23). Therefore, for patients with amyloidosis who only have renal involvement, it remains unclear whether troponin reflects the degree of renal involvement and the prognosis.…”

Section: Discussionmentioning

confidence: 99%

A prognostic staging system for light-chain amyloidosis using hepatic and renal indicator data from 1,064 Chinese patients

et al. 2021

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Background: Light-chain (AL) amyloidosis frequently involves severe multiple end-organ damage, thus affecting prognosis. As the current disease staging system is based only on cardiac indicators, we propose a new staging system based on multiple organ indicators to supplement the existing system. Methods: Patients with AL amyloidosis (n=1,064) from 18 Chinese hospitals were enrolled and divided into test and validation cohorts (4:1). Multivariate analyses were performed to identify the clinical and laboratory factors for inclusion in the new staging system.Results: A score of 1 was assigned for each of the following-the difference between the involved and uninvolved free light chains ≥100 mg/L, estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m 2 , total bilirubin (Tbil) ≥18 µmol/L, cardiac troponin I ≥0.06 µg/L, and N-terminal pro-brain natriuretic peptide (NT-proBNP) ≥3,600 pg/mL-to divide the patients into five disease stages (0 to IV). There were 220 (20.7%), 291 (27.3%), 251 (23.6%), 178 (16.7%), and 124 (11.7%) patients with stage 0, I, II, III, and IV disease, respectively. Patients with stage II, III, and IV disease had a median overall survival (OS) of 56.9 months [95% confidence interval (CI), 33.9-not reached (NR)], 18.6 months (95% CI, 33.9-NR), and 6.5 months (95% CI, 8.0-24.6) (P<0.001), respectively. The 3-year survival estimates for patients with stages 0, I, II, III, and IV were 90.7%, 71.4%, 59.4%, 39.0%, and 22.1%, respectively.Conclusions: The new staging system has been developed that incorporates plasma cell-related characteristics in addition to cardiac, renal, and hepatic function parameters. It enhances the risk stratification of patients with AL amyloidosis and is useful when multiple organs are involved.

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“…25 Although the pathophysiology remains unclear, the role of uremic myopathy leading to rhabdomyolysis, decreased troponin clearance, and hypertrophic cardiomyopathy have been suggested. [25][26][27] Dessap et al, in a study of 125 patients with acute myocardial infarction found no association between creatinine clearance and peak troponin levels. 25 Similarly, we noticed a trend of increase in peak troponin levels until grade 3 renal function, but the trend disappears in grades 4 and 5 renal function.…”

Section: Discussionmentioning

confidence: 99%

Predictors of Peak Troponin Level in Acute Coronary Syndromes: Prior Aspirin Use and SYNTAX Score

et al. 2015

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The peak troponin level has been associated with cardiovascular (CV) mortality and adverse CV events. The association of peak troponin with CV risk factors and severity and complexity of coronary artery disease remains unknown. We assessed the predictors of peak troponin in patients with acute coronary syndrome (ACS). This study aims to determine the predictors of peak troponin in ACS. Cardiac catheterization (CC) reports and electronic medical records from 2010 to 2013 were retrospectively reviewed. A total of 219 patients were eligible for the study. All major CV risk factors, comorbidities, laboratory data, CC indications, and coronary lesion characteristics were included. Univariate and multivariate regression analyses were done. On multivariate linear regression analysis, ST-elevation myocardial infarction (p?=?0.001, ??=?65.16) and increasing synergy between percutaneous coronary intervention with Taxus and cardiac surgery (SYNTAX) score (p?=?0.002, ??=?1.15) were associated with higher peak troponin. The Pearson correlation between SYNTAX score and peak troponin was r?=?0.257, p?=?0.001. History of daily aspirin use was associated with lower peak troponin (p?=?0.002, ??=??24.32). Prior statin use (p?=?0.321, ??=??8.98) and the presence of CV risk factors were not associated with peak troponin. Coronary artery disease severity and complexity, urgency of CC, and prior aspirin use are associated with peak troponin levels in ACS. Our findings may help predict patient population with ACS who would be at a greater risk for short- and long-term CV morbidity and mortality due to elevated peak troponin.

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Cardiac troponin levels in patients with impaired renal function

Abstract: Cardiac troponins are important indicators of myocardial damage. Recent studies have shown that serum cardiac troponin levels are raised in at least 50% of patients with renal disease. The mechanisms and implications of these findings are discussed.

Cited by 6 publications

References 18 publications

Correlation of Serum Cardiac Troponin I and Myocardial Damage in Cattle with Monensin Toxicosis

Correlation of Serum Cardiac Troponin I and Myocardial Damage in Cattle with Monensin Toxicosis

A prognostic staging system for light-chain amyloidosis using hepatic and renal indicator data from 1,064 Chinese patients

Predictors of Peak Troponin Level in Acute Coronary Syndromes: Prior Aspirin Use and SYNTAX Score

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