title: Improving the diagnostic accuracy of acute myocardial infarction with the use of high-sensitive cardiac troponin T in different chronic kidney disease stages.
abstract: High-sensitive cardiac troponin T (hs-TnT) is a critical biomarker in diagnosis of acute myocardial infarction (AMI). However, CKD individuals usually have elevated hs-TnT even in the absence of AMI. Our study aimed to explore the optimal cutoff-value of hs-TnT and further to improve diagnostic accuracy of AMI in CKD patients. Clinical data of 489 patients were collected from the maintained database between September 2010 and June 2014. CKD patients with AMI were assigned to CKD+AMI group and CKD patients without AMI were assigned to CKD group. Receiver operating characteristic curves were utilized to derive the optimal cutoff-value. In CKD+STEMI and CKD group, hs-TnT was increased with descending eGFR. In CKD+NSTEMI group, hs-TnT showed an upward trend with increasing SYNTAX Score. In patients with CKD+STEMI, hs-TnT was significantly correlated with SYNTAX Score in CKD stage 2, stage 4 and in total. In CKD patients, the optimal cutoff-value of hs-TnT for diagnosis of AMI was 129.45 ng/l with 75.2% sensitivity and 83.2% specificity. The cutoff-value appeared to be hs-TnT level of 99.55ng/l in CKD stage 3, 129.45 ng/l in CKD stage 4, 105.50 ng/l in CKD stage 5 and 149.35 ng/l in dialysis patients, respectively. In different stages of CKD, eGFR-range-specific optimal cutoff-values should be considered.
authors.affiliation: Division of Nephrology, Kidney Research Laboratory, West China Biostatistics and Cost Benefit Analysis Center of West China Hospital, West China Medical School, Sichuan University, Chengdu, China.
authors.forename: Hongliu
authors.initials: H
authors.lastname: Yang
authors.affiliation: Division of Nephrology, Kidney Research Laboratory, West China Biostatistics and Cost Benefit Analysis Center of West China Hospital, West China Medical School, Sichuan University, Chengdu, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Liu
authors.affiliation: Division of Thyroid Surgery, West China Hospital, West China Medical School, Sichuan University, Chengdu, China.
authors.forename: Han
authors.initials: H
authors.lastname: Luo
authors.affiliation: Division of Nephrology, Kidney Research Laboratory, West China Biostatistics and Cost Benefit Analysis Center of West China Hospital, West China Medical School, Sichuan University, Chengdu, China.
authors.forename: Xiaoxi
authors.initials: X
authors.lastname: Zeng
authors.affiliation: Division of Nephrology, Kidney Research Laboratory, West China Biostatistics and Cost Benefit Analysis Center of West China Hospital, West China Medical School, Sichuan University, Chengdu, China.
authors.forename: Xi
authors.initials: X
authors.lastname: Tang
authors.affiliation: Division of Nephrology, Kidney Research Laboratory, West China Biostatistics and Cost Benefit Analysis Center of West China Hospital, West China Medical School, Sichuan University, Chengdu, China.
authors.forename: Liang
authors.initials: L
authors.lastname: Ma
authors.affiliation: Division of Nephrology, Kidney Research Laboratory, West China Biostatistics and Cost Benefit Analysis Center of West China Hospital, West China Medical School, Sichuan University, Chengdu, China.
authors.forename: Hongxia
authors.initials: H
authors.lastname: Mai
authors.affiliation: Division of Nephrology, Kidney Research Laboratory, West China Biostatistics and Cost Benefit Analysis Center of West China Hospital, West China Medical School, Sichuan University, Chengdu, China.
authors.forename: Shenju
authors.initials: S
authors.lastname: Gou
authors.affiliation: Division of Nephrology, Kidney Research Laboratory, West China Biostatistics and Cost Benefit Analysis Center of West China Hospital, West China Medical School, Sichuan University, Chengdu, China.
authors.forename: Fang
authors.initials: F
authors.lastname: Liu
authors.affiliation: Division of Nephrology, Kidney Research Laboratory, West China Biostatistics and Cost Benefit Analysis Center of West China Hospital, West China Medical School, Sichuan University, Chengdu, China.
authors.forename: Ping
authors.initials: P
authors.lastname: Fu
mesh_terms: D000368:Aged; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000503:physiopathology; D009206:Myocardium / Q000378:metabolism*; D012372:ROC Curve; D012016:Reference Values; D051436:Renal Insufficiency, Chronic / Q000378:metabolism* / Q000503:physiopathology; D012907:Smoking / Q000009:adverse effects; D020107:Troponin T / Q000378:metabolism*
chemical_list: D020107:Troponin T