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Troponin and CKD

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26 papers 0 to 25 followers
By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
Manon Kolb, Alexandre Guinand, Marco Roffi, Patrick Saudan, Mathieu Nendaz
New assays with lower levels of detection of troponin (« high-sensitivity troponin ») increase the difficulty of interpretation of this test for the diagnosis of acute coronary syndrome in patients with chronic kidney disease (CKD). Their baseline concentration of troponin is frequently above the upper reference level, which lowers its specificity. To improve its diagnostic performance after clinical and electrocardiographic evaluation, cut-off levels 2 to 3 times higher than the standard reference have been suggested...
October 19, 2016: Revue Médicale Suisse
Flavia Ballocca, Fabrizio D'Ascenzo, Claudio Moretti, Roberto Diletti, Carlo Budano, Alberto Palazzuoli, Matthew J Reed, Tullio Palmerini, Dariusz Dudek, Alfredo Galassi, Pierluigi Omedè, Nicolas M Mieghem, David Ferenbach, Marco Pavani, Diego Della Riva, Nick L Mills, Ron T Van Domburgh, Andrea Mariani, Artur Dziewierz, Marco di Cuia, Robert Jan van Geuns, Felix Zijlstra, Serena Bergerone, Sebastiano Marra, Giuseppe Biondi Zoccai, Fiorenzo Gaita
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...
2017: Cardiology Journal
Anupama Vasudevan, Adam J Singer, Christopher DeFilippi, Gary Headden, Jeffrey M Schussler, Lori B Daniels, Michael Reed, Martin P Than, Robert Birkhahn, Stephen W Smith, Tyler W Barrett, William Arnold, W Frank Peacock, Peter A McCullough
BACKGROUND: Cardiac troponins are often found to be elevated in patients with renal dysfunction, even in the absence of acute myocardial injury. The objective of this report was to characterize the scaled troponin values and proportion of adjudicated acute myocardial infarction (AMI) among patients with and without renal dysfunction. METHODS: The data was from a multicenter prospective study including patients presenting to the emergency department with symptoms of AMI...
2017: American Journal of Nephrology
Hongliu Yang, Jing Liu, Han Luo, Xiaoxi Zeng, Xi Tang, Liang Ma, Hongxia Mai, Shenju Gou, Fang Liu, Ping Fu
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...
February 1, 2017: Scientific Reports
Helen J Jefferies, Risto Tertti, Saara Wittfooth, James O Burton, Kaj Metsärinne, Kim Pettersson, Christopher W McIntyre
Introduction Repetitive dialysis-induced cardiac injury is associated with elevated troponin levels, inflammation, and longitudinal reduction in cardiac function. Pathogenic autoantibodies to cardiac troponins (cTnAAb) produce inflammatory cardiomyopathy in murine models. This study aimed to explore the possibility that analogous autoimmune processes might occur in hemodialysis (HD) patients, by initially investigating cTnAAb prevalence, and exploring potential links with HD-induced myocardial stunning. Methods In 130 prevalent HD patients from two centers (Derby, UK; Turku, Finland), cTnAAb (immunoassay) and cardiac troponins were quantified...
November 20, 2016: Hemodialysis International
Masaki Iwasaki, Kenji Yamazaki, Nobutaka Ikeda, Yuri Tanaka, Toshihide Hayashi, Shun Kubo, Ai Matsukane, Hiroki Hase, Nobuhiko Joki
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...
November 2017: Renal Failure
Christopher R deFilippi, Charles A Herzog
BACKGROUND: Chronic kidney disease (CKD) is common, particularly in those of advanced age. Because patients with CKD frequently have cardiac comorbidities and acute or chronic symptoms that may represent heart failure or an acute myocardial infarction (AMI), testing for concentrations of cardiac troponins and natriuretic peptides is frequent. Interpretation of these biomarkers can be challenging when differentiating acute from chronic processes, potentially resulting in missed opportunities to direct appropriate treatment...
January 2017: Clinical Chemistry
Thomas A Mavrakanas, Allan D Sniderman, Paul E Barré, Ahsan Alam
AIM: This study aims to describe the variability of pre-dialysis troponin values in stable haemodialysis patients and compare the performance of single versus fluctuating or persistently elevated troponins in predicting a composite of mortality and cardiac arrest, myocardial infarction, or stroke. METHODS: 128 stable ambulatory chronic haemodialysis patients were enrolled. Pre-dialysis troponin I was measured for three consecutive months. The patients were followed for one year...
October 8, 2016: Nephrology
Wen-Hsien Lee, Po-Chao Hsu, Chun-Yuan Chu, Szu-Chia Chen, Hung-Hao Lee, Meng-Kuang Lee, Chee-Siong Lee, Hsueh-Wei Yen, Tsung-Hsien Lin, Wen-Chol Voon, Wen-Ter Lai, Sheng-Hsiung Sheu, Ho-Ming Su
The aims of this study were to investigate the correlation between renal and cardiac STIs, including pre-ejection period (PEP), ejection time (ET), and PEP/ET, and to assess the diagnostic values of renal STIs in predicting left ventricular ejection fraction (LVEF) <50%. The cross sectional observation study enrolled 230 participants. The renal STIs, including renal PEP (rPEP), renal ET (rET), and rPEP/rET, were measured from electrocardiographic gated renal Doppler ultrasound and cardiac PEP, ET, and PEP/ET were measured from echocardiography...
2016: Scientific Reports
Girish Ganesha Babu, Matthew Webber, Rui Providencia, Sanjeev Kumar, Aerakondal Gopalamurugan, Dominic P Rogers, Holly Louise Daw, Syed Ahsan, Fakhar Khan, Anthony Chow, Martin Lowe, Edward Rowland, Pier Lambiase, Oliver R Segal
BACKGROUND: Chronic kidney disease (CKD) is a risk factor for arrhythmias in patients with heart failure (HF). However, the effects of CKD on ventricular arrhythmia (VA) burden in patients with cardiac resynchronization therapy and defibrillator (CRT-D) devices in a primary prevention setting are unknown. OBJECTIVE: To determine whether baseline CKD is associated with increased risk of VA in patients implanted with primary prevention CRT-D devices. METHODS AND RESULTS: In this retrospective study, 199 consecutive primary prevention CRT-D recipients (2005-2010) were stratified by estimated glomerular filtration rate (eGFR) levels prior to device implantation with 106 (53...
October 6, 2016: Journal of Cardiovascular Electrophysiology
Anne-Sophie Bargnoux, Nils Kuster, Marion Moréna, Gregory Baptista, Leila Chenine, Stéphanie Badiou, Hélène Leray, Anne-Marie Dupuy, Jean-Paul Cristol
New highly sensitive (hs) assays have challenged the interpretation of cardiac troponins (cTn) as markers of injury while natriuretic peptides remain the markers of choice for myocardial dysfunction. However, variability extracardiac factors such as age, gender and renal function may alter circulating levels. In chronic kidney disease (CKD), the increase in circulating levels of these biomarkers in the absence of cardiac disease underlines the problem of discriminative value for diagnosis as well as the need to redefine the thresholds...
August 1, 2016: Annales de Biologie Clinique
A S Omar, P Sivadasan, S Hanoura, S Sudarsanan, Y Shouman, H Ragab, A K Tuli, R Singh, A Al Khulaifi
No abstract text is available yet for this article.
December 2015: Intensive Care Medicine Experimental
Shahram Taheri, Ali Asghar Pilehvarian, Nafiseh Akbari, Samane Musavi, Afsoon Emami Naeini
OBJECTIVE: Patients on hemodialysis (HD) have a high risk for cardiovascular morbidity and mortality. Cardiac troponins are biomarkers for diagnosing acute myocardial injury or infarction. There is considerable controversy that exists in the frequency and significance of cardiac troponins in predicting cardiac injury and ischemia in HD patients. METHODS: In this cross-sectional study, all HD patients more than 18-year-old, who were at least 3 months under HD, and had no sign and symptom of active cardiovascular disease (CVD), in two HD centers were enrolled...
April 2016: Journal of Research in Pharmacy Practice
Thomas A Mavrakanas, Allan D Sniderman, Paul E Barré, Murray Vasilevsky, Ahsan Alam
BACKGROUND: An elevated troponin level is commonly found in asymptomatic patients on hemodialysis (HD) and is associated with higher risk of mortality and major adverse cardiovascular events. The underlying mechanism for the association between adverse outcomes and elevated troponin levels has not been elucidated. METHODS: Two hundred thirty-six stable chronic HD patients from 2 tertiary care centers were enrolled in this study. We measured pre-dialysis troponin I levels with routine monthly bloods for 3 consecutive months...
2016: American Journal of Nephrology
Muthiah Vaduganathan, Deepak L Bhatt
No abstract text is available yet for this article.
2016: American Journal of Nephrology
Li Sun, Xiao Tan, Xuesen Cao, Jianzhou Zou
Objective To analyze the relationship between serum high-sensitivity cardiac troponin T (hs-cTnT) and cardiovascular disease (CVD) among non-dialysis chronic kidney disease (CKD) patients, and to further explore its value of evaluating and predicting CVD in this population. Methods Five hundred and fifty-seven non-dialysis CKD patients were involved in this cross-sectional study. The relationship between serum hs-cTnT and CVD was analyzed using comparison between groups and regression analysis, and its value on assessing cardiac structure and function was evaluated by ROC curves...
June 2016: Renal Failure
Marion A Hofmann Bowman, James K Liao
No abstract text is available yet for this article.
March 29, 2016: Circulation
Rachel M Kruzan, Charles A Herzog, Aozhou Wu, Yingying Sang, Rulan S Parekh, Kunihiro Matsushita, Seungyoung Hwang, Alan Cheng, Josef Coresh, Neil R Powe, Tariq Shafi
BACKGROUND: Sudden cardiac death (SCD) is the most common etiology of death in hemodialysis patients but not much is known about its risk factors. The goal of our study was to determine the association and risk prediction of SCD by serum N-terminal prohormone of brain natriuretic peptide (NTproBNP) troponin I (cTnI) in hemodialysis patients. METHODS: We measured NTproBNP and cTnI in 503 hemodialysis patients of a national prospective cohort study. We determined their association with SCD using Cox regression, adjusting for demographics, co-morbidities, and clinical factors and risk prediction using C-statistic and Net Reclassification Improvement (NRI)...
February 20, 2016: BMC Nephrology
Miranda van Berkel, Marijke J E Dekker, Hanneke Bogers, Daniel A Geerse, Constantijn J A M Konings, Volkher Scharnhorst
Acute myocardial infarction (AMI) is defined as a dynamic change in cardiac troponin (cTn) with at least one cTn value exceeding the 99 th percentile of a reference population in combination with typical clinical symptoms. In hemodialysis (HD) patients, a broad range of cTn concentrations is found, partially due to patient-specific comorbidities. Therefore, the 99 th percentile cannot be used in HD patients and decision algorithms to diagnose AMI should be based on temporal variations of troponin. In this study, relative and absolute variations of cTn in a large population of asymptomatic hemodialysis patients were established during a period of 15 months...
May 1, 2016: Clinica Chimica Acta; International Journal of Clinical Chemistry
Mehrdad Jafari Fesharaki, Saeed Alipour Parsa, Mohsen Nafar, Maryam Ghaffari-Rahbar, Fatemeh Omidi, Hamidreza Karimi-Sari
INTRODUCTION: Myocardial infarction is a common cause of mortality in patients with chronic kidney disease (CKD). Since troponins I and T levels rise in CKD patients without any myocardial cause, diagnostic value of cardiac troponins is not high in these patients. This study aimed to evaluate the value of troponin I and other cardiac biomarkers to differentiate acute coronary syndrome in CKD patients. MATERIALS AND METHODS: In this cross-sectional study, patients with stage 3 to 5 of CKD with typical chest pain were enrolled...
January 2016: Iranian Journal of Kidney Diseases
2016-02-08 09:04:01
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