title: Cardiac troponin T in acute coronary syndrome with renal insufficiency.
abstract: Cardiac troponin levels are frequently elevated in patients with chronic renal failure, hence diagnosis of myocardial necrosis is difficult. The prevalence of elevated serum troponin T was determined and its diagnostic value in acute coronary syndrome was assessed in patients with chronic renal insufficiency. A retrospective cross-sectional analysis was performed in 227 patients with chronic renal insufficiency and a diagnosis of unstable angina, non-ST or ST-segment elevation myocardial infarction. All patients had baseline serum troponin T levels measured at previous visits; the baseline troponin T level was raised in 53.3%. Cardiac troponin T levels did not correlate with creatinine levels, and were not affected by dialysis. Mortality after an acute coronary event was high (46.3%). Because of the elevated baseline cardiac troponin T levels, detection of acute coronary syndrome in patients with chronic renal failure requires evaluation of serial cardiac enzyme measurements and serial 12-lead electrocardiograms. Early and definitive cardiac interventions may contribute towards decreasing the mortality rate in this group of patients.
authors.affiliation: Department of Respiratory and Critical Care Medicine, Singapore General Hospital, Outram Road, Singapore. chinnjing@pacific.net.sg
authors.forename: Huck Chin
authors.initials: HC
authors.lastname: Chew
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D006328:Cardiac Catheterization; D003404:Creatinine / Q000097:blood; D003430:Cross-Sectional Studies; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000097:blood* / Q000150:complications / Q000175:diagnosis; D011379:Prognosis; D051437:Renal Insufficiency / Q000097:blood* / Q000150:complications; D012189:Retrospective Studies; D012720:Severity of Illness Index; D020107:Troponin T / Q000097:blood*
chemical_list: D015415:Biomarkers; D020107:Troponin T; D003404:Creatinine