The appropriate troponin T level associated with coronary occlusions in chronic kidney disease patients.
BACKGROUND
High-sensitivity troponin T (HS Trop T) plays an important role as a diagnostic marker for acute coronary syndrome. It is also related to cardiovascular outcomes. HS Trop T levels may be varied in individuals with renal dysfunction. This study aimed to find the appropriate HS Trop T cutoff points in chronic kidney disease (CKD) patients who had coronary artery occlusion.


METHODS
The study was conducted at the Emergency Department, Ramathibodi Hospital, Mahidol University, Thailand. CKD patients stage 3-5 who had HS Trop T levels after 2 hours of chest pain and had coronary angiographic results were enrolled. Patients were divided into two groups: those who had significant occlusion of more than 70% of a coronary artery as the coronary artery disease (CAD) group and the non-CAD group.


RESULTS
In total, 210 patients met the study criteria. There were 132 patients (62.86%) who had significant stenosis of coronary arteries by coronary angiograms. The average age (standard deviation) of all patients was 71.02 (9.49) years. HS Trop T levels were significantly higher in all CKD patients with CAD than the non-CAD group (0.4973 versus 0.0384 ng/mL). Sex and HS Trop T levels were significantly associated with CAD by multivariate logistic regression analysis. The HS Trop T level of 0.041 ng/mL gave sensitivity and specificity of 65.91% and 75.65%, respectively, for CAD.


CONCLUSIONS
The HS Trop T level of 0.041 ng/mL provided diagnostic properties for established coronary artery occlusion in CKD patients.
Department of Emergency Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Yuwares
Y
Sittichanbuncha
Department of Emergency Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Pungkava
P
Sricharoen
Department of Emergency Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Panvilai
P
Tangkulpanich
Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand ; Research Center in Back, Neck, Other Joint Pain and Human Performance (BNOJPH), Khon Kaen University, Khon Kaen, Thailand.
Kittisak
K
Sawanyawisuth
acute coronary syndrome; chronic kidney disease; coronary angiogram; coronary artery occlusion; high-sensitivity troponin T; sensitivity; specificity