[Cardiac troponin I determination in patients with chronic renal failure].
OBJECTIVE
The aim of the study was evaluate cardiac troponin I (cTnI) determination in patients with chronic renal failure (CRF) and compare with creatine kinase-MB isoenzyme (CK-MB and CK-MB/CK).


METHODS
We performed a retrospective study on patients with CRF with MDRD (modification of diet in renal disease study group) < 60 mL/min admitted with suspected myocardial injury by history, physical examination and electrocardiography. cTnI measurement was assessed at admission with the ACCESS analyzer (Beckman).


RESULTS
Acute myocardial injury (AMI) was diagnosed in 10% (47/467) patients with cTnI determination > 0.05 ng/mL, while the diagnostic was angina in 9% (41/467) and in 81% (379/467) we finded other diagnostics. In the AMI group, 49% had chest discomfort, 43% diabetes and the mortality was 45%, while in the angina group were 41%, 32% and 7%, respectively. The sensitivity for cTnI with cut-off value > 0.5 ng/mL was 70% and specificity 92%. The number of false positives was 31% (20 patients).


CONCLUSIONS
cTnI is the preferred biomarker for myocardial damage in patients with CRF. Other cut-off value could enhance the sensitivity for AMI.
Flores
L M
LM
Servicio de Análisis Clínicos, Complejo Hospitalario de Ourense, Universitario de Santiago de Compostela.
Hernández Dominguez
J L
JL
Otero
A
A
González Juanatey
J R
JR
D000368:Aged; D000369:Aged, 80 and over; D000787:Angina Pectoris / Q000097:blood* / Q000150:complications / Q000401:mortality; D015415:Biomarkers; D002637:Chest Pain / Q000209:etiology; D003402:Creatine Kinase / Q000097:blood; D052279:Creatine Kinase, MB Form / Q000097:blood; D048909:Diabetes Complications / Q000097:blood; D005189:False Positive Reactions; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D006973:Hypertension / Q000150:complications; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000150:complications; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000150:complications / Q000401:mortality; D009206:Myocardium / Q000378:metabolism*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012907:Smoking; D019210:Troponin I / Q000097:blood*
D015415:Biomarkers; D019210:Troponin I; D003402:Creatine Kinase; D052279:Creatine Kinase, MB Form