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Chronic elevation of cardiac troponin I predicts the extent of coronary disease in hemodialysis patients presenting with acute enzyme elevation.
Taha, Mohamad B; Taha, Ahmad B; Dasa, Osama; Alom, Modar; Abdelgadir, Yasir H; Winchester, David E.
Afiliación
  • Taha MB; Department of Medicine, University of Florida College of Medicine, Gainesville, FL, United States.
  • Taha AB; Department of Internal Medicine, Detroit Medical Center (Sinai-Grace Hospital), Wayne State University School of Medicine, Detroit, MI, United States.
  • Dasa O; Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
  • Alom M; Department of Medicine, University of Florida College of Medicine, Gainesville, FL, United States.
  • Abdelgadir YH; Department of Internal Medicine, Detroit Medical Center (Sinai-Grace Hospital), Wayne State University School of Medicine, Detroit, MI, United States.
  • Winchester DE; Department of Medicine, University of Toledo, Toledo, OH, United States.
Am Heart J Plus ; 2: 100012, 2021 Feb.
Article en En | MEDLINE | ID: mdl-38560585
ABSTRACT

Introduction:

Elevation of cardiac troponin I (cTn-I) is associated with coronary artery disease (CAD) in asymptomatic patients with end-stage renal disease (ESRD) receiving hemodialysis. We aim to investigate the diagnostic value of chronically elevated cTn-I in ESRD patients presenting with an acute rise in serum cTn-I levels.

Methods:

We performed a retrospective analysis of 364 patients. Using coronary angiography, we correlated baseline elevation of cTn-I with the severity of CAD when hemodialysis patients present with acute symptomatic elevation in serum cTn-I.

Results:

In hemodialysis patients presenting with a rise in serum cTn-I above baseline levels, 59% had severe CAD, and 17% had no angiographic evidence of CAD. Hemodialysis patients with severe CAD had significantly higher baseline cTn-I levels compared to patients with non-severe CAD or normal coronaries (p < 0.0001). Baseline elevation of cTn-I in the severe CAD group was correlated with the degree of CAD occlusion (r2 0.56, p < 0.0001), fitting a positive linear model. Furthermore, baseline cTn-I differentiates between patients with and without severe CAD with a test accuracy of 0.72 (95% CI, 0.69-0.75, p < 0.001). At a value of ≥0.2 ng/mL (cutoff for myocardial necrosis), the specificity of baseline cTn-I for underlying severe CAD was 0.95.

Conclusions:

Elevated baseline cTn-I has good accuracy for anticipating more advanced angiographic CAD when hemodialysis patients present with a symptomatic rise in serum cTn-I above baseline levels. Baseline elevation of cTn-I can be used for cardiac disease risk management in hemodialysis patients presenting with symptoms suggestive of CAD.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Am Heart J Plus Año: 2021 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Am Heart J Plus Año: 2021 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos