High sensitive TROponin levels In Patients with Chest pain and kidney disease: A multicenter registry — The TROPIC study

Abstract

Background: Accuracy of high sensitive troponin (hs-cTn) to detect coronary artery disease (CAD) in CAD (0.2 ± 0.8 vs. 8.9 ± 4.6 ng/mL; p = 0.04) and AUC was more accurate for troponin I than hs-cTnT (AUC 0.85 vs. 0 CAD or thrombus (0.4 ± 0.6 vs. 15 ± 20 ng/mL; p = 0.02;; no differences were found for troponin T assays (0.8 ± 1.5 vs. 2.2 ± 3.6 ng/mL; p = 1.7),. Peak troponin levels (both T and I) (Cardiol J 2017; 24, 2: 139-150) .69). Peak level was greater for hs-cTnI in patients with

Chronic Elevation of Troponin I Predicts the Extent of Coronary Artery Disease in Hemodialysis Patients Presenting with Acute Enzyme Elevation

“…Therefore, the higher the baseline cTn-I values, the more likely the presentation is due to more advanced CAD. This was in line with previous studies showing that patients presenting with altered cTn are at high risk of coronary stenosis [10], and baseline cTn-I are rarely elevated without evidence of CAD in hemodialysis patients [11]. Moreover, a previous study showed that not only a negative cTn-I identi es patients at low risk of MI and 30-day cardiac mortality, but also those with cTn-I levels at or above the 99th percentile had a 2-fold increased risk of MI and cardiac death at one year [12].…”

“…Categorical variables were presented as frequencies and percentages, while continuous variables were presented as means ± standard deviation (SD) or standard error of the mean (SEM). cTn-I values were transformed to their corresponding log 10 to reduce data skewness and to use other analysis methods. The normality of data distribution was tested using the D'Agostino-Pearson normality test at 95% con dence.…”

High Sensitivity Cardiac Troponin T in Patients with Severe Chronic Kidney Disease and suspected Acute Coronary Syndrome

“…In our study coronary angiography was used as the most accurate exam to objectify outcomes in this diagnostically very challenging population. So far there are only very few studies, all with major methodological issues, considering the presence of significant coronary stenosis at coronary angiography as a reference in comparison with different cTnT assays [37][38][39]. Of these, only the one by Ballocca et al [37] applied an hs-cTnT assay, obtaining a poor AUC for the prediction of AMI in patients with chest pain and CKD.…”

“…So far there are only very few studies, all with major methodological issues, considering the presence of significant coronary stenosis at coronary angiography as a reference in comparison with different cTnT assays [37][38][39]. Of these, only the one by Ballocca et al [37] applied an hs-cTnT assay, obtaining a poor AUC for the prediction of AMI in patients with chest pain and CKD. Most of the recent studies have used clinical diagnosis of AMI, without carrying out coronary angiography for all their patients [19][20][21][22][23][24].…”

Cardiorenal biomarkers: one step closer

“…It indicates that renal function might be less important for cTnI clearance compared with cTnT, possibly due to greater susceptibility of cTnT in uremia, leading to accumulating smaller cTnT fragments (17) with relatively free passage through the glomerular filtration barrier. Interestingly, a recent study showed that hs-cTnI was superior to hs-cTnT in detecting coronary artery disease among CKD patients (18), possibly because hs-cTnT is more dependent on renal elimination. Conversely, hs-cTnT outperformed hs-cTnI in predicting all-cause mortality in CKD patients (19).…”