title: High sensitive TROponin levels In Patients with Chest pain and kidney disease: A multicenter registry - The TROPIC study.
abstract: BACKGROUND
  Accuracy of high sensitive troponin (hs-cTn) to detect coronary artery disease (CAD) in patients with renal insufficiency is not established. The aim of this study was to evaluate the prognostic role of hs-cTn T and I in patients with chronic kidney disease (CKD).
  
  
  METHODS
  All consecutive patients with chest pain, renal insufficiency (eGFR < 60 mL/min/1.73 m2) and high sensitive troponin level were included. The predictive value of baseline and interval troponin (hs-cTnT and hs-cTnI) for the presence of CAD was assessed.
  
  
  RESULTS
  One hundred and thirteen patients with troponin I and 534 with troponin T were included, with 95 (84%) and 463 (87%) diagnosis of CAD respectively. There were no differences in clinical, procedural and outcomes between the two assays. For both, baseline hs-cTn values did not differ be-tween patients with/without CAD showing low area under the curve (AUC). For interval levels, hs-cTnI was significantly higher for patients with CAD (0.2 ± 0.8 vs. 8.9 ± 4.6 ng/mL; p = 0.04) and AUC was more accurate for troponin I than hs-cTnT (AUC 0.85 vs. 0.69). Peak level was greater for hs-cTnI in patients with CAD or thrombus (0.4 ± 0.6 vs. 15 ± 20 ng/mL; p = 0.02; AUC 0.87: 0.79-0.93); no differences were found for troponin T assays (0.8 ± 1.5 vs. 2.2 ± 3.6 ng/mL; p = 1.7), with lower AUC (0.73: 0.69-0.77). Peak troponin levels (both T and I) independently predicted all cause death at 30 days.
  
  
  CONCLUSIONS
  Patients with CKD presenting with altered troponin are at high risk of coronary disease. Peak level of both troponin assays predicts events at 30 days, with troponin I being more accurate than troponin T. (Cardiol J 2017; 24, 2: 139-150).
authors.affiliation: Departement of Cardiology, Division of Internal Medicine, Città Della Salute e della Scienza. flaviabl@hotmail.it.
authors.forename: Flavia
authors.initials: F
authors.lastname: Ballocca
authors.forename: Fabrizio
authors.initials: F
authors.lastname: D'Ascenzo
authors.forename: Claudio
authors.initials: C
authors.lastname: Moretti
authors.forename: Roberto
authors.initials: R
authors.lastname: Diletti
authors.forename: Carlo
authors.initials: C
authors.lastname: Budano
authors.forename: Alberto
authors.initials: A
authors.lastname: Palazzuoli
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Reed
authors.forename: Tullio
authors.initials: T
authors.lastname: Palmerini
authors.forename: Dariusz
authors.initials: D
authors.lastname: Dudek
authors.forename: Alfredo
authors.initials: A
authors.lastname: Galassi
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Omedè
authors.forename: Nicolas M
authors.initials: NM
authors.lastname: Mieghem
authors.forename: David
authors.initials: D
authors.lastname: Ferenbach
authors.forename: Marco
authors.initials: M
authors.lastname: Pavani
authors.forename: Diego
authors.initials: D
authors.lastname: Della Riva
authors.forename: Nick L
authors.initials: NL
authors.lastname: Mills
authors.forename: Ron T
authors.initials: RT
authors.lastname: Van Domburgh
authors.forename: Andrea
authors.initials: A
authors.lastname: Mariani
authors.forename: Artur
authors.initials: A
authors.lastname: Dziewierz
authors.forename: Marco
authors.initials: M
authors.lastname: di Cuia
authors.forename: Robert
authors.initials: R
authors.lastname: Jan van Geuns
authors.forename: Felix
authors.initials: F
authors.lastname: Zijlstra
authors.forename: Serena
authors.initials: S
authors.lastname: Bergerone
authors.forename: Sebastiano
authors.initials: S
authors.lastname: Marra
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Biondi Zoccai
authors.forename: Fiorenzo
authors.initials: F
authors.lastname: Gaita
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D002637:Chest Pain / Q000097:blood* / Q000175:diagnosis / Q000209:etiology; D003324:Coronary Artery Disease / Q000097:blood* / Q000150:complications / Q000175:diagnosis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011379:Prognosis; D012372:ROC Curve; D012042:Registries; D051436:Renal Insufficiency, Chronic / Q000097:blood* / Q000150:complications; D015203:Reproducibility of Results; D012189:Retrospective Studies; D019210:Troponin I / Q000097:blood*; D020107:Troponin T / Q000097:blood*
chemical_list: D015415:Biomarkers; D019210:Troponin I; D020107:Troponin T
keywords: chronic kidney disease; coronary artery disease; high sensitive troponin