title: Serum Troponin I Level for Diagnosis of Acute Coronary Syndrome in Patients with Chronic Kidney Disease.
abstract: BACKGROUND
  Myocardial infarction is a common cause of mortality in patients with chronic kidney disease (CKD). Since troponins I and T levels rise in CKD patients without any myocardial cause, diagnostic value of cardiac troponins is not high in these patients. This study aimed to evaluate the value of troponin I and other cardiac biomarkers to differentiate acute coronary syndrome in CKD patients.
  
  
  METHODS
  In this cross-sectional study, patients with stage 3 to 5 of CKD with typical chest pain were enrolled. Troponins I and T and other biomarkers were measured, and angiography was carried out in these patients. Cardiac biomarkers and other variables were evaluated in patients and compared with angiography results.
  
  
  RESULTS
  Ninety CKD patients with a mean age of 61.67 ± 15.87 years were enrolled. Angiography results were normal in 48.9% of the patients, while it showed single-vessel disease in 14.5%, two-vessel disease in 23.3%, and three-vessel disease in 13.3%. Serum creatinine level, glomerular filtration rate, troponin I level, and creatine kinase level were not significantly different in patients with normal and abnormal angiography findings. The serum troponin I, creatine kinase, and creatine kinase-myocardial bound levels had no significant diagnostic values to differentiate abnormal angiography in CKD patients.
  
  
  CONCLUSIONS
  Serum levels of cardiac troponin I and creatine kinase-myocardial bound were not suitable to diagnose ACS in CKD patients (stages 3 to 5); therefore, we suggest using other diagnostic attempts in similar conditions. More evaluation is needed to confirm these findings.
authors.forename: Mehrdad
authors.initials: M
authors.lastname: Jafari Fesharaki
authors.forename: Saeed
authors.initials: S
authors.lastname: Alipour Parsa
authors.forename: Mohsen
authors.initials: M
authors.lastname: Nafar
authors.forename: Maryam
authors.initials: M
authors.lastname: Ghaffari-Rahbar
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Omidi
authors.affiliation: Students' Research Committee, Baqiyatallah University of Medical Sciences, Tehran, Iran. dr.karimih@yahoo.com.
authors.forename: Hamidreza
authors.initials: H
authors.lastname: Karimi-Sari
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood* / Q000150:complications / Q000175:diagnosis*; D000328:Adult; D000368:Aged; D000792:Angiography; D015415:Biomarkers / Q000097:blood; D002637:Chest Pain / Q000209:etiology; D052279:Creatine Kinase, MB Form / Q000097:blood; D003404:Creatinine / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D019210:Troponin I / Q000097:blood*; D020107:Troponin T / Q000097:blood
chemical_list: D015415:Biomarkers; D019210:Troponin I; D020107:Troponin T; D003404:Creatinine; D052279:Creatine Kinase, MB Form