Differential use of cardiac troponin T versus I in hemodialysis patients.
نویسندگان
چکیده
BACKGROUND Cardiac troponin T (cTnT) is frequently elevated in asymptomatic hemodialysis (HD) patients and predicts increased cardiovascular morbidity and mortality. Compared to cTnT, cardiac troponin I (cTnI) has a shorter half-life. How this influences its diagnostic reliability in chronic HD patients is only partially known. PATIENTS AND METHODS First, in a cross-sectional study cardiac troponins were measured in 31 asymptomatic HD patients. A third-generation cTnT assay was used. The rate of false positive tests and the intraindividual variability were determined. Second, in a retrospective analysis over 12 months all acute events with clinical suspicion for acute coronary syndrome (ACS) were analysed in the same patients to determine the diagnostic power of cTnT by receiver-operating curve (ROC) plot. RESULTS Cross-sectional study: 9 of 52 (17%) cTnT and 0/52 cTnI (0%) tests were positive in asymptomatic HD patients with a low intraindividual variability. Retrospective analysis: 16 acute clinical events with determination of cTnT were recorded, and in 4/16 an ACS was diagnosed. Using a cut-off level of 0.1 microg/l, the cTnT test reached a sensitivity of 100%, a specificity of 42%, a positive predicitive value of 36% and a negative predictive value of 100%, using a cut-off level of 0.2 microg/l the corresponding values were 75%, 58%, 38% and 88%. CONCLUSIONS Cardiac TnT, but only rarely cTnI, is elevated in a significant number of asymptomatic HD patients. For diagnosis of ACS in HD patients, a combination of cTnT and cTnI may be used, since the former has higher sensitivity and the latter higher specificity. A higher threshold value for cTnT in HD patients could further increase its diagnostic accuracy.
منابع مشابه
Analysis of the relation between coping ways with stress and Cardiac Biomarker Troponin I in coronary heart disease patients
Introduction: Coping ways with stress in coronary heart disease patients can lead to significant changes in levels of Cardiac Biomarker Troponin I, but researchers had not explored it empirically. So, the main objective of this study was to identify the relationship between coping ways with stress and Cardiac Biomarker Troponin I and also, finding coping ways that predict changes in the concent...
متن کاملCorrelation between the Level of Creatinine, Serum Cardiac Troponines and Left Ventricle Function Tests in Patients with Chronic Renal Diseases without Acute Coronary Syndrome
Background and Objectives: The aim of this study was to survey the relationship between the level of creatinine,cardiac troponins serum and the function of the left ventricle in patients with kidney insufficiency,without acute coronary syndrome. Materialsand Methods:The sample was150 patients with nondialysis chronic kidney disease without acute coronary syndrome, hospitalized at I...
متن کاملPrognostic value of serum cardiac troponin I in ambulatory patients with chronic renal failure undergoing long-term hemodialysis: a two-year outcome analysis.
OBJECTIVES We sought to evaluate the prognostic value of cardiac troponin I (cTnI) in asymptomatic, ambulatory patients with chronic renal failure treated with long-term hemodialysis. BACKGROUND Smaller, short-term follow-up studies on this subject have given conflicting results. METHODS A total of 126 ambulatory patients with chronic renal failure treated with long-term hemodialysis were f...
متن کاملThe most sensitive double-marker method of cardiac isoenzymes of creatinine kinase, troponin I, and myoglobin in different time periods for diagnosing acute myocardial infarction
Purpose: Myocardial infarction is among the most common diagnoses in patients admitted to hospitals in western countries, and its rapid diagnosis is of utmost importance. This study was conducted to determine the most sensitive double-marker cardiac isoenzyme of creatinine kinase, troponin I, and myoglobin for diagnosing acute myocardial infarction. Materials and Methods: This was an ...
متن کاملValues of troponin T and myoglobin predictive of non-cardiac ischemia in rats
Objective(s):Biochemical markers are important for the timely diagnosis and follow-up of ischemic events. Most of the markers have been previously studied in the context of cardiac ischemia. However, research on markers of non-cardiac events has been insufficient. Therefore, we investigated the relationship between troponin and myoglobin which are commonly used markers of cardiac ischemia, in n...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Clinical nephrology
دوره 59 1 شماره
صفحات -
تاریخ انتشار 2003