open access

Vol 24, No 2 (2017)
Original articles — Interventional cardiology
Published online: 2017-03-09
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High sensitive TROponin levels In Patients with Chest pain and kidney disease: A multicenter registry — The TROPIC study

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
DOI: 10.5603/CJ.a2017.0025
·
Pubmed: 28281735
·
Cardiol J 2017;24(2):139-150.

open access

Vol 24, No 2 (2017)
Original articles — Interventional cardiology
Published online: 2017-03-09

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 be­tween 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)

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 be­tween 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)

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Keywords

high sensitive troponin, chronic kidney disease, coronary artery disease

About this article
Title

High sensitive TROponin levels In Patients with Chest pain and kidney disease: A multicenter registry — The TROPIC study

Journal

Cardiology Journal

Issue

Vol 24, No 2 (2017)

Pages

139-150

Published online

2017-03-09

DOI

10.5603/CJ.a2017.0025

Pubmed

28281735

Bibliographic record

Cardiol J 2017;24(2):139-150.

Keywords

high sensitive troponin
chronic kidney disease
coronary artery disease

Authors

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

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