title: Point of care assessment of cardiac troponin T level in CKD patients with chest symptom.
abstract: We challenged to identify the cutoff value of cTnT in chronic kidney disease (CKD) patients by point of care assessment way. A single center, prospective cross-sectional study was planned and performed. 201 consecutive patients who were visited emergency room for chest symptoms were enrolled in this study. All patients were performed routine practice for differential diagnosis of chest symptom by cardiologist. Simultaneously, semiquantitative measurement of cTnT was performed using same blood sampling on the blind condition to cardiologists for this study. Study patients were divided into four groups according to the estimated glomerular filtration rate (eGFR), CKD1-2, CKD3, CKD4-5, and CKD5D. Usefulness of semiquantitative measurement for diagnosing ACEs was investigated in each group. 77 (38%) of total patient was diagnosed as acute coronary events (ACEs). About 50% of patients were showing cTnT level less than 0.03 ng/mL. The cTnT level over 0.1 ng/mL was found in 30% of total subjects. Mean quantitative value of cTnT was 0.29 ± 0.57 ng/mL in total subjects. Estimated cutoff value in CKD3 patients was 0.088 ng/mL with a sensitivity of 59.3% and specificity of 80.0%. Interestingly, the cutoff values of CKD1-2, CKD4-5, and CKD5D were 0.047, 0.18, and 0.27 respectively, which are half, two times, and three times of CKD3 cutoff value 0.088. The specificities of four cutoff values in each CKD group were showing over 80%, which is higher than sensitivity, respectively. In CKD patients, semiquantitative, point of care assessment of cTnT could be a useful tool for screening for ACEs.
authors.affiliation: a Division of Nephrology , Toho University Ohashi Medical Center , Tokyo , Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Iwasaki
authors.affiliation: b Divisions of Cardiovascular Medicine , Odawara Cardiovascular Hospital , Kanagawa , Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Yamazaki
authors.affiliation: c Divisions of Cardiovascular Medicine , Toho University Ohashi Medical Center , Tokyo , Japan.
authors.forename: Nobutaka
authors.initials: N
authors.lastname: Ikeda
authors.affiliation: a Division of Nephrology , Toho University Ohashi Medical Center , Tokyo , Japan.
authors.forename: Yuri
authors.initials: Y
authors.lastname: Tanaka
authors.affiliation: a Division of Nephrology , Toho University Ohashi Medical Center , Tokyo , Japan.
authors.forename: Toshihide
authors.initials: T
authors.lastname: Hayashi
authors.affiliation: a Division of Nephrology , Toho University Ohashi Medical Center , Tokyo , Japan.
authors.forename: Shun
authors.initials: S
authors.lastname: Kubo
authors.affiliation: a Division of Nephrology , Toho University Ohashi Medical Center , Tokyo , Japan.
authors.forename: Ai
authors.initials: A
authors.lastname: Matsukane
authors.affiliation: a Division of Nephrology , Toho University Ohashi Medical Center , Tokyo , Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Hase
authors.affiliation: a Division of Nephrology , Toho University Ohashi Medical Center , Tokyo , Japan.
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Joki
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D003324:Coronary Artery Disease / Q000097:blood / Q000175:diagnosis*; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D019095:Point-of-Care Systems; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000145:classification* / Q000150:complications*; D012680:Sensitivity and Specificity; D020107:Troponin T / Q000097:blood*
chemical_list: D015415:Biomarkers; D020107:Troponin T
keywords: cTnT; coronary artery disease; cutoff; semi-quantitative