Value of the high-sensitivity troponin T assay for diagnosis of acute myocardial infarction in patients with and without renal insufficiency

Cheng Kai Hsu, I. Wen Wu, Yih Ting Chen, Chia Huei Peng, Yi Ju Tseng, Yung Chang Chen, Ming Jui Hung, Yu Cheng Kao

研究成果: 雜誌貢獻文章同行評審

4 引文 斯高帕斯(Scopus)

摘要

Background
Cardiac troponins are important markers for diagnosis of acute myocardial infarction (AMI) in general population; however, chronically-elevated troponins levels are often seen in patients with renal insufficiency, which reduce their diagnostic accuracy. The aim of our study was to access the diagnostic values of initial high-sensitive cardiac troponin T (hs-cTnT) and relative change of hs-cTnT for AMI in patients with and without renal insufficiency.

Methods
Cardiac care unit patients with elevated hs-cTnT levels in 2017–2018 were enrolled. Receiver operating characteristic (ROC) curves were used to evaluate initial hs-cTnT levels and relative changes after 3 h of enrollment for diagnosis of AMI in patients with estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2 (low), and eGFR ≥ 60 mL/min/1.73 m2 (normal).

Results
Of 359 patients, 240 patients had low eGFR, and 119 patients had normal eGFR. The area under the ROC curve (AUC) for the initial hs-cTnT levels was 0.58 (95% CI, 0.5–0.65, p = 0.053) among patients with low eGFR and 0.54 (95% CI, 0.4–0.67, p = 0.612) among patients with normal eGFR. AUCs for relative changes of hs-cTnT were 0.82 (95% CI, 0.76–0.88, p < 0.001) in patients with low eGFR and 0.82 (95% CI, 0.71–0.91, p < 0.001) in patients with normal eGFR. Optimal cutoff values for the relative changes in hs-cTnT were 16% and 12% in patients with low eGFR and normal eGFR, respectively.

Conclusions
Relative changes in hs-cTnT levels had better diagnostic accuracy than initial hs-cTnT levels.
原文英語
頁(從 - 到)1142-1151
頁數10
期刊Renal Failure
42
發行號1
DOIs
出版狀態已發佈 - 11月 2020
對外發佈

ASJC Scopus subject areas

  • 重症監護和重症監護醫學
  • 腎臟病學

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