Daijin Ren1, Tianlun Huang1, Xin Liu1, Gaosi Xu2. 1. Department of Nephrology, The Second Affiliated Hospital of Nanchang University, No. 1, Minde Road, Donghu District, Nanchang, 330006, People's Republic of China. 2. Department of Nephrology, The Second Affiliated Hospital of Nanchang University, No. 1, Minde Road, Donghu District, Nanchang, 330006, People's Republic of China. gaosixu@163.com.
Abstract
BACKGROUND: Chronic kidney disease (CKD) are associated with acute myocardial infarction (AMI). High-sensitive cardiac troponin (hs-cTn) has been evidenced to enhance the early diagnostic accuracy of AMI, but hs-cTn levels are often chronically elevated in CKD patients, which reduces their diagnostic utility. The aim of this study was to derive optimal cutoff-values of hs-cTn levels in patients with CKD and suspected AMI. METHODS: In this retrospective paper, a total of 3295 patients with chest pain (2758 in AMI group and 537 in Non-AMI group) were recruited, of whom 23.1% were had an estimated glomerular filtration rate (eGFR) of < 60 mL min-1 (1.73 m2)-1. Hs-cTnI values were measured at presentation. RESULTS: AMI was diagnosed in 83.7% of all patients. The optimal value of hs-TnI in diagnosing AMI was 1.15 ng mL-1, which were higher in males than females comparing different cutoff-values of subgroups divided by age, gender and renal function, and which increased monotonically with decreasing of eGFR because in patients with CKD without AMI, the correlation between hs-cTnI and renal function is low but significant (r2 = 0.067, P < 0.001). CONCLUSIONS: Different optimal cutoff-values of hs-cTnI in the diagnosis of AMI in patients with CKD were helpful to the clinical diagnosis of AMI in various populations and were higher in males than females, but which was needed to be validated by multicenter randomized controlled clinical studies in the future.
BACKGROUND:Chronic kidney disease (CKD) are associated with acute myocardial infarction (AMI). High-sensitive cardiac troponin (hs-cTn) has been evidenced to enhance the early diagnostic accuracy of AMI, but hs-cTn levels are often chronically elevated in CKDpatients, which reduces their diagnostic utility. The aim of this study was to derive optimal cutoff-values of hs-cTn levels in patients with CKD and suspected AMI. METHODS: In this retrospective paper, a total of 3295 patients with chest pain (2758 in AMI group and 537 in Non-AMI group) were recruited, of whom 23.1% were had an estimated glomerular filtration rate (eGFR) of < 60 mL min-1 (1.73 m2)-1. Hs-cTnI values were measured at presentation. RESULTS: AMI was diagnosed in 83.7% of all patients. The optimal value of hs-TnI in diagnosing AMI was 1.15 ng mL-1, which were higher in males than females comparing different cutoff-values of subgroups divided by age, gender and renal function, and which increased monotonically with decreasing of eGFR because in patients with CKD without AMI, the correlation between hs-cTnI and renal function is low but significant (r2 = 0.067, P < 0.001). CONCLUSIONS: Different optimal cutoff-values of hs-cTnI in the diagnosis of AMI in patients with CKD were helpful to the clinical diagnosis of AMI in various populations and were higher in males than females, but which was needed to be validated by multicenter randomized controlled clinical studies in the future.
Authors: Véronique L Roger; Alan S Go; Donald M Lloyd-Jones; Emelia J Benjamin; Jarett D Berry; William B Borden; Dawn M Bravata; Shifan Dai; Earl S Ford; Caroline S Fox; Heather J Fullerton; Cathleen Gillespie; Susan M Hailpern; John A Heit; Virginia J Howard; Brett M Kissela; Steven J Kittner; Daniel T Lackland; Judith H Lichtman; Lynda D Lisabeth; Diane M Makuc; Gregory M Marcus; Ariane Marelli; David B Matchar; Claudia S Moy; Dariush Mozaffarian; Michael E Mussolino; Graham Nichol; Nina P Paynter; Elsayed Z Soliman; Paul D Sorlie; Nona Sotoodehnia; Tanya N Turan; Salim S Virani; Nathan D Wong; Daniel Woo; Melanie B Turner Journal: Circulation Date: 2011-12-15 Impact factor: 29.690
Authors: Nagesh S Anavekar; John J V McMurray; Eric J Velazquez; Scott D Solomon; Lars Kober; Jean-Lucien Rouleau; Harvey D White; Rolf Nordlander; Aldo Maggioni; Kenneth Dickstein; Steven Zelenkofske; Jeffrey D Leimberger; Robert M Califf; Marc A Pfeffer Journal: N Engl J Med Date: 2004-09-23 Impact factor: 91.245
Authors: Caroline S Fox; Paul Muntner; Anita Y Chen; Karen P Alexander; Matthew T Roe; Christopher P Cannon; Jorge F Saucedo; Michael C Kontos; Stephen D Wiviott Journal: Circulation Date: 2010-01-11 Impact factor: 29.690
Authors: Maciej T Wybraniec; Maria Bożentowicz-Wikarek; Jerzy Chudek; Katarzyna Mizia-Stec Journal: Int J Cardiovasc Imaging Date: 2016-12-19 Impact factor: 2.357
Authors: Raphael Twerenbold; Patrick Badertscher; Jasper Boeddinghaus; Thomas Nestelberger; Karin Wildi; Christian Puelacher; Zaid Sabti; Maria Rubini Gimenez; Sandra Tschirky; Jeanne du Fay de Lavallaz; Nikola Kozhuharov; Lorraine Sazgary; Deborah Mueller; Tobias Breidthardt; Ivo Strebel; Dayana Flores Widmer; Samyut Shrestha; Òscar Miró; F Javier Martín-Sánchez; Beata Morawiec; Jiri Parenica; Nicolas Geigy; Dagmar I Keller; Katharina Rentsch; Arnold von Eckardstein; Stefan Osswald; Tobias Reichlin; Christian Mueller Journal: Circulation Date: 2017-11-03 Impact factor: 29.690