title: Moderate renal dysfunction is not associated with elevated Troponin T in acute coronary syndromes.
abstract: BACKGROUND
  Interpretation of troponin results in patients with acute coronary syndromes (ACS) and renal disease is confused by the fact that renal dysfunction increases troponin levels, regardless of myocardial necrosis. Although it has been demonstrated that end-stage renal disease is associated with elevated cardiac troponin T (cTnT) levels, it is not known whether this biomarker is altered by less than severe degrees of renal impairment.
  
  
  OBJECTIVE
  To evaluate whether moderate renal dysfunction is associated with cTnT elevation in patients with ACS.
  
  
  METHODS
  One hundred, forty-five individuals with ACS and creatinine clearance > 30 ml/min were studied. Creatinine clearance was estimated by the Cockcroft-Gault formula and cTnT was measured at hospital admission. Moderate renal dysfunction was defined as a creatinine clearance of 30-59 ml/min and positive cTnT as levels > 0.01 ug/l.
  
  
  RESULTS
  No correlation was observed between creatinine clearance and cTnT (r = - 0.06, P=0.45). The levels of cTnT were similar among individuals in the first (median=0.05 ug/l), second (median=0 ug/l), third (median=0.07 ug/l) and fourth quartiles (median=0 ug/l) of creatinine clearance - P=0.63. Similarly, there was no difference in troponin values between individuals with moderate renal dysfunction (median=0.02 ug/l) and individuals with normal/near normal function (median=0.03 ug/l) - P=0.63. The prevalence of positive cTnT was similar between individuals with moderate renal dysfunction and normal/near normal renal function (55% vs 52%, P=0.65).
  
  
  CONCLUSIONS
  Moderate renal dysfunction is not associated with cTnT elevation in patients with ACS.
authors.affiliation: Escola Bahiana de Medicina, Hospital Português, Salvador, BA - Brazil. lccorreia@terra.com.br
authors.forename: Luis C L
authors.initials: LC
authors.lastname: Correia
authors.forename: Carolina E
authors.initials: CE
authors.lastname: Barbosa
authors.forename: Thais
authors.initials: T
authors.lastname: Cerqueira
authors.forename: Ana
authors.initials: A
authors.lastname: Vasconcelos
authors.forename: Saulo
authors.initials: S
authors.lastname: Merelles
authors.forename: Tiago
authors.initials: T
authors.lastname: Reis
authors.forename: José C
authors.initials: JC
authors.lastname: Lima
authors.forename: J Péricles
authors.initials: JP
authors.lastname: Esteves
authors.forename: Marcela S
authors.initials: MS
authors.lastname: Teixeira
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood*; D000368:Aged; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D003404:Creatinine / Q000097:blood*; D005260:Female; D006801:Humans; D007668:Kidney / Q000502:physiology; D008297:Male; D012016:Reference Values; D051437:Renal Insufficiency / Q000097:blood*; D020107:Troponin T / Q000097:blood*
chemical_list: D015415:Biomarkers; D020107:Troponin T; D003404:Creatinine