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A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion
Published on: February 2, 2021
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Troponin Cut-Offs for Acute Myocardial Infarction in Patients with Impaired Renal Function-A Systematic Review and
Jan Kampmann1,2, James Heaf3, Christian Backer Mogensen2,4
1Internal Medicine Research Unit, University Hospital of Southern Denmark, Sydvang 1, 6400 Sonderborg, Denmark.
Diagnostics (Basel, Switzerland)
|February 25, 2022
Summary
Diagnosing heart attacks in kidney disease patients is challenging. This meta-analysis suggests higher troponin T and troponin I cut-off values for acute myocardial infarction diagnosis in these patients.
Area of Science:
- Cardiology
- Nephrology
- Biomarkers
Background:
- Acute myocardial infarction (AMI) diagnosis is complicated in renal disease patients due to atypical symptoms and elevated baseline troponin.
- Standard troponin cut-off values may lead to misdiagnosis in patients with impaired kidney function.
Purpose of the Study:
- To determine specific troponin T and troponin I cut-off values for diagnosing AMI in patients with renal impairment using a meta-analysis.
- To address the diagnostic challenges posed by renal disease in cardiac biomarker interpretation.
Main Methods:
- A comprehensive literature search was conducted across major databases (MEDLINE, Embase, PubMed, Web of Science, Cochrane Library).
- Fifteen relevant articles investigating alternative troponin cut-offs in renal impairment were included.
- Six studies were pooled for meta-analysis to establish diagnostic cut-offs.
Main Results:
- The meta-analysis suggested a troponin I cut-off of 42 ng/L and a troponin T cut-off of 48 ng/L for AMI in renal impairment.
- For patients undergoing dialysis, a higher troponin T cut-off of 239 ng/L was indicated.
- Data limitations prevented establishing a troponin I cut-off for dialysis patients.
Conclusions:
- Established troponin cut-off values require adjustment for patients with kidney disease to improve AMI diagnosis.
- Further research is necessary to refine troponin cut-offs, particularly for dialysis patients, and to address study heterogeneity.
- Improved diagnostic criteria are crucial for accurate AMI identification in the renal impairment population.
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