scholarly journals FP403ASSOCIATION BETWEEN SERUM OSTEOPROTEGERIN & SERUM HIGH SENSITIVITY CARDIAC TROPONIN T LEVELS WITH CARDIOVASCULAR CALCIFICATION IN CHRONIC KIDNEY DISEASE

2018 ◽  
Vol 33 (suppl_1) ◽  
pp. i170-i171
Author(s):  
Waleed Elrefaey ◽  
Mohamed H Abou Freikha ◽  
Kamal M Okasha ◽  
Medhat M Ashmawy ◽  
Heba A Mourad ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Cardiac Troponin ◽  
Troponin T ◽  
High Sensitivity ◽  
Cardiac Troponin T

scholarly journals High Sensitivity Cardiac Troponin T in Patients with Severe Chronic Kidney Disease and suspected Acute Coronary Syndrome

2021 ◽  
Author(s):  
Brunilda Alushi ◽  
Fabian Jost-Brinkmann ◽  
Adnan Kastrati ◽  
Salvatore Cassese ◽  
Massimiliano Fusaro ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Cardiac Troponin ◽  
Troponin T ◽  
High Sensitivity ◽  
Cardiac Troponin T ◽  
Reference Limit ◽  
Coronary Syndrome ◽  
Severe Chronic Kidney Disease ◽  
Cutoff Levels

Background: Patients with severe chronic kidney disease (CKD G4-G5) often have chronically elevated high-sensitivity cardiac troponin T (hs-cTnT) values above the 99th percentile of the upper reference limit. In these patients, optimal cutoff levels for diagnosing non-ST-elevation acute cor-onary syndrome (NSTE-ACS) requiring revascularization remain undefined. Methods: Of 11,912 patients undergoing coronary angiography from 2012 to 2017 for suspected NSTE-ACS, 325 (3%) had severe CKD. Of these, 290 with available serial hs-cTnT measurements were included and 300 matched patients with normal renal function were selected as a control cohort. Results: Diagnostic performance for patients with severe CKD was high at presentation and similar to that of the control population (AUC, 95% CI: 0.81, 0.75-0.87 versus 0.85, 0.80-0.89, p=0.68) and the ROC-derived cutoff value at presentation was 4 times higher compared to the conventional 99th percentile. Combining the ROC-derived cutoff levels for hs-cTnT at presentation and absolute 3-hour changes, sensitivity increased to 98%, PPV and NPV improved up to 93% and 86%, re-spectively. (4) Conclusions: In patients with severe CKD and suspected ACS the diagnostic accu-racy of hs-cTnT for the diagnosis of NSTE-ACS requiring revascularization is improved by using higher assay specific cutoff levels combined with early absolute changes.

FP401ASSOCIATION BETWEEN SERUM OSTEOPROTEGERIN & SERUM HIGH SENSITIVITY CARDIAC TROPONIN T LEVEL IN CHRONIC KIDNEY DISEASE

2018 ◽  
Vol 33 (suppl_1) ◽  
pp. i169-i169
Author(s):  
Kamal Okasha ◽  
Waleed A Elrefaey ◽  
Mohamed H Abou Freikha ◽  
Medhat M Ashmawy ◽  
Heba A Mourad
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Cardiac Troponin ◽  
Troponin T ◽  
High Sensitivity ◽  
Cardiac Troponin T

scholarly journals High-Sensitivity Cardiac Troponin T in Patients with Severe Chronic Kidney Disease and Suspected Acute Coronary Syndrome

2021 ◽  
Vol 10 (18) ◽  
pp. 4216
Author(s):  
Brunilda Alushi ◽  
Fabian Jost-Brinkmann ◽  
Adnan Kastrati ◽  
Salvatore Cassese ◽  
Massimiliano Fusaro ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Acute Coronary Syndrome ◽  
Kidney Disease ◽  
Cardiac Troponin ◽  
Troponin T ◽  
High Sensitivity ◽  
Cardiac Troponin T ◽  
Coronary Syndrome ◽  
Severe Chronic Kidney Disease ◽  
Cutoff Levels

(1) Background: Patients with severe chronic kidney disease (CKD G4–G5) often have chronically elevated high-sensitivity cardiac troponin T (hs-cTnT) values above the 99th percentile of the upper reference limit. In these patients, optimal cutoff levels for diagnosing non-ST-elevation acute coronary syndrome (NSTE-ACS) requiring revascularization remain undefined. (2) Methods: Of 11,912 patients undergoing coronary angiography from 2012 to 2017 for suspected NSTE-ACS, 325 (3%) had severe CKD. Of these, 290 with available serial hs-cTnT measurements were included, and 300 matched patients with normal renal function were selected as a control cohort. (3) Results: In the CKD cohort, 222 patients (76%) had NSTE-ACS with indication for coronary revascularization. Diagnostic performance was high at presentation and similar to that of the control population (AUC, 95% CI: 0.81, 0.75–0.87 versus 0.85, 0.80–0.89, p = 0.68), and the ROC-derived cutoff value was 4 times higher compared to the conventional 99th percentile. Combining the ROC-derived cutoff levels for hs-cTnT at presentation and absolute 3 h changes, sensitivity increased to 98%, and PPV and NPV improved up to 93% and 86%, respectively. (4) Conclusions: In patients with severe CKD and suspected ACS, the diagnostic accuracy of hs-cTnT for the diagnosis of NSTE-ACS requiring revascularization is improved by using higher assay-specific cutoff levels combined with early absolute changes.

scholarly journals Biological variation of cardiac troponins in chronic kidney disease

2020 ◽  
Vol 57 (2) ◽  
pp. 162-169
Author(s):  
RA Jones ◽  
J Barratt ◽  
EA Brettell ◽  
P Cockwell ◽  
RN Dalton ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Cardiac Troponin ◽  
Troponin I ◽  
Troponin T ◽  
Biological Variation ◽  
Cardiac Troponin I ◽  
Cardiac Troponin T ◽  
Reference Change Value

Background Patients with chronic kidney disease often have increased plasma cardiac troponin concentration in the absence of myocardial infarction. Incidence of myocardial infarction is high in this population, and diagnosis, particularly of non ST-segment elevation myocardial infarction (NSTEMI), is challenging. Knowledge of biological variation aids understanding of serial cardiac troponin measurements and could improve interpretation in clinical practice. The National Academy of Clinical Biochemistry (NACB) recommended the use of a 20% reference change value in patients with kidney failure. The aim of this study was to calculate the biological variation of cardiac troponin I and cardiac troponin T in patients with moderate chronic kidney disease (glomerular filtration rate [GFR] 30–59 mL/min/1.73 m2). Methods and results Plasma samples were obtained from 20 patients (median GFR 43.0 mL/min/1.73 m2) once a week for four consecutive weeks. Cardiac troponin I (Abbott ARCHITECT® i2000SR, median 4.3 ng/L, upper 99th percentile of reference population 26.2 ng/L) and cardiac troponin T (Roche Cobas® e601, median 11.8 ng/L, upper 99th percentile of reference population 14 ng/L) were measured in duplicate using high-sensitivity assays. After outlier removal and log transformation, 18 patients’ data were subject to ANOVA, and within-subject (CVI), between-subject (CVG) and analytical (CVA) variation calculated. Variation for cardiac troponin I was 15.0%, 105.6%, 8.3%, respectively, and for cardiac troponin T 7.4%, 78.4%, 3.1%, respectively. Reference change values for increasing and decreasing troponin concentrations were +60%/–38% for cardiac troponin I and +25%/–20% for cardiac troponin T. Conclusions The observed reference change value for cardiac troponin T is broadly compatible with the NACB recommendation, but for cardiac troponin I, larger changes are required to define significant change. The incorporation of separate RCVs for cardiac troponin I and cardiac troponin T, and separate RCVs for rising and falling concentrations of cardiac troponin, should be considered when developing guidance for interpretation of sequential cardiac troponin measurements.

Prognostic Significance of Cardiac Troponin-T Level in Chronic Kidney Disease Patients on Hemodialysis

2014 ◽  
Vol 1 (2) ◽  
pp. 60
Author(s):  
MunnaLal Patel ◽  
Rekha Sachan ◽  
Pankaj Singh ◽  
Pushplata Sachan ◽  
ShyamChand Chaudhary ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Cardiac Troponin ◽  
Troponin T ◽  
Prognostic Significance ◽  
Cardiac Troponin T
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