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Cardiac troponin T + renal clearance

Marie Caujolle, Jerome Allyn, Caroline Brulliard, Dorothée Valance, David Vandroux, Olivier Martinet, Nicolas Allou
Purpose: The aim of this study was to assess the determinants and prognostic value of high-sensitivity cardiac troponin T peak plasma concentration in intensive care unit patients with non-cardiogenic shock. Material and methods: A prospective observational cohort study was conducted in a single intensive care unit between November 2014 and December 2015. Results: During the study period, 206 patients were hospitalized in the intensive care unit for non-cardiogenic shock and the median peak high-sensitivity cardiac troponin T was 55...
2018: SAGE Open Medicine
Hector Cubero-Gallego, Maria Heredia-Rodriguez, Eduardo Tamayo
We aimed to assess the influence of impairment in renal function over the high-sensitivity cardiac troponin T (hs-cTnT) accuracy to diagnose perioperative myocardial infarction (MI) after heart valve surgery. Heart valve surgery was performed in 805 patients from June 2012 to January 2016. Patients with enzymatic curves of hs-cTnT suggestive of myocardial necrosis and electrocardiogram and/or transthoracic echocardiogram criteria were identified as patients with perioperative MI. Impairment in renal function was defined as a postoperative creatinine clearance <50 ml/min at 16 h after surgery and for at least 48 h...
March 12, 2018: Interactive Cardiovascular and Thoracic Surgery
Claudio Moretti, Enrico Cerrato, Erika Cavallero, Song Lin, Marco Luciano Rossi, Andrea Picchi, Francesca Sanguineti, Fabrizio Ugo, Alberto Palazzuoli, Maurizio Bertaina, Patrizia Presbitero, Chen Shao-Liang, Roberto Pozzi, Massimo Giammaria, Ugo Limbruno, Thierry Lefèvre, Valeria Gasparetto, Roberto Garbo, Pierluigi Omedè, Imad Sheiban, Javier Escaned, Giuseppe Biondi-Zoccai, Fiorenzo Gaita, Leor Perl, Fabrizio D'Ascenzo
BACKGROUND: The potential protective effects of remote ischemic preconditioning (RIPC) on contrast-induced nephropathy (CIN) after percutaneous coronary intervention (PCI) remain to be defined. METHODS AND RESULTS: A double blind, randomized, placebo controlled multicenter study was performed. Patients younger than 85years old, with a renal clearance of 30-60ml/min/1.73m2 , who were candidates for PCI for all clinical indications except for primary PCI, were allocated 1:1 to RIPC or to standard therapy...
April 15, 2018: International Journal of Cardiology
Vincent Fridén, Karin Starnberg, Aida Muslimovic, Sven-Erik Ricksten, Christian Bjurman, Niklas Forsgard, Anna Wickman, Ola Hammarsten
OBJECTIVE: The extent of kidney-dependent clearance of the cardiac damage biomarker cardiac troponin T (cTnT) is not known. METHODS AND RESULTS: We examined clearance of cTnT after injection of heart extracts in rats with or without clamped kidney vessels. The extent of degradation of cTnT to fragments able to pass the glomerular membrane and the kidney extraction index of cTnT was examined in human subjects. After a bolus injection of rat cardiac extract, simulating a large myocardial infarction, there was no significant difference in clearance of cTnT with or without kidney function...
June 2017: Clinical Biochemistry
Amr S Omar, Khaled Mahmoud, Samy Hanoura, Hany Osman, Praveen Sivadasan, Suraj Sudarsanan, Yasser Shouman, Rajvir Singh, Abdulaziz AlKhulaifi
BACKGROUND: The value of cardiac troponin as a risk assessment tool for cardiac disease in the setting of end-stage renal diseases (ESRD) is not equivalent to its value in those with normal renal function. This consideration had not been studied in settings of acute kidney injury (AKI). We aim to explore the diagnostic value of high sensitive troponin T (hsTnT) in the settings of cardiac surgery-induced AKI. METHODS: Single center observational retrospective study...
January 31, 2017: BMC Anesthesiology
T Gresslien, S Agewall
Cardiac troponins are the preferred biomarkers in diagnostic of myocardial infarction, but these markers also can rise in response to exercise. Multiple studies have assessed troponins post-exercise, but the results have varied and there have been disagreements about the mechanism of troponin release. The aim of this paper was to review the literature, and to consider factors and mechanisms regarding exercise-induced increase of troponin. 145 studies were found after a search in pubmed and inclusion of additional articles found in the reference list of the first articles...
October 15, 2016: International Journal of Cardiology
Mira T Keddis, Hatem Amer, Nikolay Voskoboev, Walter K Kremers, Andrew D Rule, John C Lieske
BACKGROUND AND OBJECTIVES: eGFR equations have been evaluated in kidney transplant recipients with variable performance. We assessed the performance of the Modification of Diet in Renal Disease equation and the Chronic Kidney Disease Epidemiology Collaboration equations on the basis of creatinine, cystatin C, and both (eGFR creatinine-cystatin C) compared with measured GFR by iothalamate clearance and evaluated their non-GFR determinants and associations across 15 cardiovascular risk factors...
September 7, 2016: Clinical Journal of the American Society of Nephrology: CJASN
Jason Zhi Yong Chung, Graham Ross Dallas Jones
BACKGROUND: Elevations of serum cardiac troponin T (cTnT) have been described in patients with end stage chronic kidney disease (CKD) although the mechanism is unknown, whether from increased production or decreased clearance. Less is known about cTnT in short term changes in renal function and in lesser degrees of renal impairment. OBJECTIVES: This study aimed to investigate the effect of renal function changes on cTnT within individuals and characterise the distribution of cTnT according to renal function in the population...
August 2015: Clinical Biochemistry
Christian Bjurman, Max Petzold, Per Venge, Julia Farbemo, Michael L X Fu, Ola Hammarsten
BACKGROUND: Elevation of cardiac markers in patients with renal dysfunction has not been fully assessed reducing the diagnostic usefulness of these biomarkers. OBJECTIVE: To examine the effects of renal function and a medical record of cardiovascular disease on levels of cardiac biomarkers. METHODS: Serum samples were collected from 489 patients referred for GFR measurement using Cr51-EDTA or iohexol plasma clearance (measured GFR). The cardiac biomarkers Troponin T (hs-cTnT), Troponin I (hsTnI), N-Terminal pro-Brain Natriuretic Peptide (NTproBNP), Copeptin, Human Fatty Acid-Binding Protein (hFABP), as well as the kidney function biomarkers creatinine and cystatin C, were measured...
March 2015: Clinical Biochemistry
Ravi H Parikh, Stephen L Seliger, Christopher R deFilippi
It is well known that the population with chronic kidney disease (CKD) is at greater risk for cardiovascular disease and death than the general population. The use and interpretation of high sensitivity cardiac troponin (hs-cTn) assays have been particularly challenging in these patients with the majority having elevated levels at baseline. The diagnostic accuracy of acute myocardial infarction (AMI) may be decreased in patients with CKD when using these newer troponins. In order to improve the sensitivity and specificity for the diagnosis of AMI, one must look at the change in cTn and consider using higher cut-off values...
March 2015: Clinical Biochemistry
Gates Colbert, Nishank Jain, James A de Lemos, S Susan Hedayati
Cardiac biomarkers, such as cardiac troponin T (cTnT), brain natriuretic peptide (BNP), and N-terminal-pro-BNP (NT-pro-BNP), are commonly used to diagnose acute coronary syndrome and congestive heart failure exacerbation in symptomatic patients. Levels of these biomarkers are frequently chronically elevated in asymptomatic patients with ESRD who are receiving maintenance dialysis. Other imaging biomarkers commonly encountered in nephrologists' clinical practice, such as coronary artery calcium measured by computed tomography, left ventricular hypertrophy, and carotid intima-media thickness, are also frequently abnormal in asymptomatic patients with ESRD...
March 6, 2015: Clinical Journal of the American Society of Nephrology: CJASN
Luis C L Correia, Carolina E Barbosa, Thais Cerqueira, Ana Vasconcelos, Saulo Merelles, Tiago Reis, José C Lima, J Péricles Esteves, Marcela S Teixeira
BACKGROUND: Interpretation of troponin results in patients with acute coronary syndromes (ACS) and renal disease is confused by the fact that renal dysfunction increases troponin levels, regardless of myocardial necrosis. Although it has been demonstrated that end-stage renal disease is associated with elevated cardiac troponin T (cTnT) levels, it is not known whether this biomarker is altered by less than severe degrees of renal impairment. OBJECTIVE: To evaluate whether moderate renal dysfunction is associated with cTnT elevation in patients with ACS...
October 2010: Arquivos Brasileiros de Cardiologia
Luis C L Correia, Carolina E Barbosa, Thais Cerqueira, Ana Vasconcelos, Saulo Merelles, Tiago Reis, José C Lima, J Péricles Esteves, Marcela S Teixeira
BACKGROUND: Interpretation of troponin results in patients with acute coronary syndromes (ACS) and renal disease is confused by the fact that renal dysfunction increases troponin levels, regardless of myocardial necrosis. Although it has been demonstrated that end-stage renal disease is associated with elevated cardiac troponin T (cTnT) levels, it is not known whether this biomarker is altered by less than severe degrees of renal impairment. OBJECTIVE: To evaluate whether moderate renal dysfunction is associated with cTnT elevation in patients with ACS...
August 27, 2010: Arquivos Brasileiros de Cardiologia
Takayoshi Tsutamoto, Chiho Kawahara, Masayuki Yamaji, Keizo Nishiyama, Masanori Fujii, Takashi Yamamoto, Minoru Horie
AIMS: Both serum cardiac troponin T (cTnT) and renal function are prognostic predictors in patients with chronic heart failure (CHF). We aimed to evaluate the relationship between renal function and serum cTnT. METHODS AND RESULTS: We measured serum concentrations of cTnT in the aortic root (AO) and coronary sinus (CS) in 258 CHF patients. Patients were divided into two groups: patients with an estimated glomerular filtration rate (eGFR) >or= 60 mL/min/1.73 m(2) [chronic kidney disease (CKD)(-)], and patients with an eGFR < 60 mL/min/1...
July 2009: European Journal of Heart Failure
Songsak Kiatchoosakun, Dujdao Sahasthas, Chaiyasith Wongvipaporn, Cholatip Pongskul
BACKGROUND: Cardiac troponin T level (cTnT) is commonly increased in end stage chronic kidney disease (CKD) in the absence of acute myocardial infarction. There are few data available on serum cTnT concentration in patients with pre-end stage CKD. OBJECTIVE: To evaluate the correlation of cTnT level and severity of kidney disease in patients with CKD stage 3 and 4 and to evaluate whether there is a relationship between left ventricular mass index and cTnT level...
December 2008: Journal of the Medical Association of Thailand, Chotmaihet Thangphaet
Paul O Collinson, David C Gaze
Cardiac biomarkers have a complex interrelationship with disease pathophysiology in patients with renal dysfunction. The underlying clinical condition results in a direct effect on the normal release and clearance of cardiac troponins and natriuretic peptides. Although initial reports suggested that this might prove a major limitation in the routine clinical use of these markers, a combination of improved assay performance and a better understanding of the underlying biochemistry of these markers in health and disease has clarified the situation...
2008: Scandinavian Journal of Clinical and Laboratory Investigation. Supplementum
Regine Wiessner, Kurt Hannemann-Pohl, Reinhard Ziebig, Herko Grubitzsch, Berthold Hocher, Ortrud Vargas-Hein, Andreas Lun, Ingolf Schimke, Lutz Liefeldt
BACKGROUND: To date, there have been no studies reliably showing an influence of the kidney on the concentration of troponins. We therefore analysed the concentration curves in patients after coronary artery bypass grafting (CABG) according to their dependence on renal function. METHODS: We determined cardiac troponin I (cTnI), cardiac troponin T (cTnT) and creatinine in plasma in 28 patients after CABG. Discrimination into patients with normal (n=13) and impaired (n=15) renal function was based on creatinine clearance (Crea-Clear)...
January 2008: Nephrology, Dialysis, Transplantation
C K Wong, C C Szeto, M H M Chan, C B Leung, P K T Li, C W K Lam
Chronic renal failure (CRF) patients suffer from a chronic inflammation. They are at increased risk of cardiovascular disease. In order to investigate this inflammatory process and cardiovascular risk factors associated with haemodialysis (HD) and peritoneal dialysis (PD), we compared serum/plasma pro-inflammatory cytokines, C-reactive protein (CRP), and cardiac troponin T (cTnT) of 146 CRF patients treated or not treated with PD or HD. Serum cytokines and CRP as well as plasma cTnT were measured by enzyme-linked immunosorbent assay, chemiluminescence immunoassay, and electrochemiluminescence immunoassay, respectively...
2007: Immunological Investigations
Christopher R DeFilippi, Jeffrey C Fink, Caitlin M Nass, Hegang Chen, Robert Christenson
BACKGROUND: N-Terminal pro-B-type natriuretic peptide (NT-proBNP) level predicts underlying heart disease in the general population. However, because NT-proBNP clearance may depend on renal function, the significance of an elevated level in patients with chronic kidney disease (CKD) without cardiac symptoms is uncertain. We sought to determine whether there is an association between NT-proBNP level and coronary artery disease (CAD) and left ventricular hypertrophy (LVH) in this population...
July 2005: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Radovan Hojs
Atherosclerosis is accelerated in dialysis patients and cardiovascular mortality is up to 20 times higher than in the general population. Cardiac troponin T (cTnT) is a sensitive marker of myocardial necrosis and studies have confirmed the superiority of this marker over traditional cardiac enzymes. Elevated cTnT has been observed in patients with various degrees of renal failure and treatment modalities in the absence of an acute coronary event. The possibility that increased troponins reflect decreased clearance or analytical interference from uremic serum is unlikely...
June 2005: Therapeutic Apheresis and Dialysis
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