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Cardiac troponin elevations in chronic renal failure: prevalence and clinical significance
1Department of Cardiology, Ospedale Civile, Ivrea, Italy. mussop@ivrea.alpcom.it
Insights
Mildly elevated cardiac troponin T (cTnT) is common in chronic renal failure (CRF) patients but does not indicate adverse cardiac events. Cardiac troponin I (cTnI) levels remained normal in most CRF patients.
Area of Science:
- Cardiology
- Nephrology
- Clinical Chemistry
Background:
- Chronic renal failure (CRF) is associated with increased cardiovascular risk.
- Biomarkers of cardiac injury, such as cardiac troponins, are crucial for diagnosing acute myocardial infarction.
- The behavior of cardiac troponin T (cTnT) and cardiac troponin I (cTnI) in CRF patients without other cardiac comorbidities requires clarification.
Purpose of the Study:
- To determine the prevalence of abnormal cardiac troponin T (cTnT) and cardiac troponin I (cTnI) values in patients with chronic renal failure (CRF).
- To assess the clinical significance and prognostic value of elevated cTnT and cTnI in CRF patients.
Main Methods:
- Investigated cTnT and cTnI concentrations in 49 CRF patients without heart disease or diabetes.
- Measured cTnT using a second-generation immunoassay and cTnI using two immunoassays of varying analytical sensitivity.
- Monitored CRF patients for 18 months for clinical outcomes.
Main Results:
- Elevated cTnT levels above the upper reference limit were observed in 47% of CRF patients.
- Cardiac troponin I (cTnI) values were normal in most patients, with only two showing minimally elevated results with one assay.
- Elevated cTnT concentrations were below levels seen in acute myocardial infarction and did not correlate with adverse cardiac events during follow-up.
Conclusions:
- Mildly elevated cardiac troponin T (cTnT) concentrations are frequent in patients with chronic renal failure (CRF).
- These mildly elevated cTnT levels in CRF patients do not appear to predict adverse coronary events.
- Cardiac troponin I (cTnI) may be a more specific biomarker for acute cardiac events in CRF populations.
Objectives:
The aim of the study was investigate the prevalence of abnormal values of cardiac troponin T (cTnT) and cardiac troponin I (cTnI) in patients with chronic renal failure (CRF) and their clinical significance.
Design And Methods:
We investigated the concentrations of cTnT and cTnI in 49 CRF patients without heart disease or diabetes. Cardiac TnT values were measured with a second generation immunoassay and cTnI with two immunoassays with different analytical sensitivity. All CRF patients underwent regular clinical follow-up over a 18-month period.
Results:
No patients with CRF had elevated values of cTnI when measured with one assay and only 2 patients displayed minimally elevated values with the second assay. In contrast, 23 CRF patients (47%) displayed cTnT concentrations elevated above the upper reference limit. The elevated cTnT values observed were below the values detected in acute myocardial infarction and were not associated with adverse cardiac events during follow-up.
Conclusions:
Mildly elevated cTnT concentrations are common in patients with CRF and do not appear to be associated with adverse coronary events.