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The appropriate troponin T level associated with coronary occlusions in chronic kidney disease patients

Yuwares Sittichanbuncha1, Pungkava Sricharoen1, Panvilai Tangkulpanich1

  • 1Department of Emergency Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.

Therapeutics and Clinical Risk Management
|September 9, 2015
PubMed

Insights

A high-sensitivity troponin T (HS Trop T) level of 0.041 ng/mL is a useful cutoff for diagnosing coronary artery occlusion in chronic kidney disease (CKD) patients. This finding aids in identifying cardiovascular disease in this vulnerable population.

Area of Science:

  • Cardiology
  • Nephrology
  • Biomarkers

Background:

  • High-sensitivity troponin T (HS Trop T) is a key marker for acute coronary syndrome and cardiovascular outcomes.
  • Renal dysfunction can affect HS Trop T levels, necessitating specific diagnostic considerations.
  • Chronic kidney disease (CKD) patients often present with atypical symptoms, complicating diagnosis.

Purpose of the Study:

  • To determine appropriate HS Trop T cutoff points for diagnosing coronary artery occlusion in CKD patients.
  • To evaluate the diagnostic performance of HS Trop T in identifying significant coronary artery disease (CAD) in this population.
  • To establish a reliable biomarker threshold for cardiovascular events in CKD.

Main Methods:

  • Prospective study of 210 CKD patients (stage 3-5) presenting with chest pain.
  • Coronary angiography was performed to confirm coronary artery occlusion (defined as >70% stenosis).
  • HS Trop T levels were measured, and logistic regression analysis was used to identify significant predictors of CAD.

Main Results:

  • 132 patients (62.86%) had significant coronary artery stenosis.
  • HS Trop T levels were significantly higher in CKD patients with CAD (0.4973 ng/mL) compared to non-CAD (0.0384 ng/mL).
  • A HS Trop T cutoff of 0.041 ng/mL demonstrated 65.91% sensitivity and 75.65% specificity for CAD.

Conclusions:

  • The HS Trop T level of 0.041 ng/mL has diagnostic utility for coronary artery occlusion in CKD patients.
  • This cutoff aids in the diagnosis of coronary artery disease in individuals with impaired renal function.
  • Further research may refine HS Trop T thresholds for improved cardiovascular risk stratification in CKD.
Abstract

Keywords:
acute coronary syndromechronic kidney diseasecoronary angiogramcoronary artery occlusionhigh-sensitivity troponin Tsensitivityspecificity

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