title: Does percutaneous nephrolithotomy cause elevated cardiac troponins?
abstract: BACKGROUND
  Percutaneous nephrolithotomy is the treatment of choice in large and staghorn renal stones, and myocardial infarction is one the possible complications during and after the surgery. We investigated if renal and skeletal muscle injury, caused by percutaneous nephrolithotomy, can cause elevation in cardiac troponins (cTn).
  
  
  METHODS
  This study was conducted on otherwise healthy patients with renal stone undergoing percutaneous nephrolithotomy. A baseline 12-lead electrocardiogram, echocardiography, and cTn assessment confirmed no cardiac pathology in any patients. Cardiac troponins T (cTnT) and I (cTnI), and also creatine kinase (CK) were assessed before and after surgery.
  
  
  RESULTS
  A total of 55 patients (69.1% males, mean age: 40.5 ± 13.8 year) were included. Serum creatinine level ranged from 0.7 to 1.3 mg/dl (mean = 1.03 ± 0.17). The level of CK was significantly increased by 469.5 ± 201.4 U/l (P < 0.001), and no positive cTnT or cTnI was observed after surgery.
  
  
  CONCLUSIONS
  The results of the present study showed that renal cell injury, caused by percutaneous nephrolithotomy, is not associated with elevated cardiac troponins. These findings show that increasing troponins in patients undergoing percutaneous nephrolithotomy indicate a cardiovascular pathology.
authors: Associate Professor, Hypertension Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
authors: Hassan
authors: H
authors: Shemirani
authors: Department of Internal Medicine AND Isfahan Cardiovascular Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
authors: Reza
authors: R
authors: Khanjani
authors: Assistant Professor, Department of Urology AND Urology and Kidney Transplantation Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors: Mehrdad
authors: M
authors: Mohammadi-Sichani
authors: Medical Student Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors: Sarah
authors: S
authors: Mozafarpour
authors: Hypertension Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
authors: Majid
authors: M
authors: Rabbani
authors: Cardiac Rehabilitation Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
authors: Javad
authors: J
authors: Shahabi
keywords: Acute Coronary Syndrome; Cardiac Markers; Coronary Artery Disease; Percutaneous Nephrolithotomy; Troponin