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. 2015 Aug 4:11:1143-7.
doi: 10.2147/TCRM.S85671. eCollection 2015.

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

Yuwares Sittichanbuncha  1 , Pungkava Sricharoen  1 , Panvilai Tangkulpanich  1 , Kittisak Sawanyawisuth  2
Affiliations

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

Yuwares Sittichanbuncha et al. Ther Clin Risk Manag. .

Abstract

Background: High-sensitivity troponin T (HS Trop T) plays an important role as a diagnostic marker for acute coronary syndrome. It is also related to cardiovascular outcomes. HS Trop T levels may be varied in individuals with renal dysfunction. This study aimed to find the appropriate HS Trop T cutoff points in chronic kidney disease (CKD) patients who had coronary artery occlusion.

Patients and methods: The study was conducted at the Emergency Department, Ramathibodi Hospital, Mahidol University, Thailand. CKD patients stage 3-5 who had HS Trop T levels after 2 hours of chest pain and had coronary angiographic results were enrolled. Patients were divided into two groups: those who had significant occlusion of more than 70% of a coronary artery as the coronary artery disease (CAD) group and the non-CAD group.

Results: In total, 210 patients met the study criteria. There were 132 patients (62.86%) who had significant stenosis of coronary arteries by coronary angiograms. The average age (standard deviation) of all patients was 71.02 (9.49) years. HS Trop T levels were significantly higher in all CKD patients with CAD than the non-CAD group (0.4973 versus 0.0384 ng/mL). Sex and HS Trop T levels were significantly associated with CAD by multivariate logistic regression analysis. The HS Trop T level of 0.041 ng/mL gave sensitivity and specificity of 65.91% and 75.65%, respectively, for CAD.

Conclusion: The HS Trop T level of 0.041 ng/mL provided diagnostic properties for established coronary artery occlusion in CKD patients.

Keywords: acute coronary syndrome; chronic kidney disease; coronary angiogram; coronary artery occlusion; high-sensitivity troponin T; sensitivity; specificity.

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Figures

Figure 1
Figure 1
Receiver operating characteristic (ROC) curve of high-sensitivity troponin T levels and coronary artery disease in all patients (n=210).
Figure 2
Figure 2
Receiver operating characteristic (ROC) curve of high-sensitivity troponin T levels and coronary artery disease in chronic kidney disease stage 3 (n=166).
Figure 3
Figure 3
Receiver operating characteristic (ROC) curve of high-sensitivity troponin T levels and coronary artery disease in chronic kidney disease stages 4 and 5 (n=44).
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