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La Rivista Italiana della Medicina di Laboratorio 2020 Marzo;16(1):44-9

DOI: 10.23736/S1825-859X.20.00050-X


lingua: Inglese

Influence of glomerular function on values of cardiac troponin T in patients with suspected acute coronary syndrome

Marco BUSSETTI 1 , Vincenzo ROCCAFORTE 1, Ruggero BUONOCORE 1, Fabrizio CAPPELLINI 2, Giammaria LIUZZI 1, Massimo DAVES 3, Roberto CEMIN 4, Silvia BURATI 1, Marta C. TOSCA 1, Rosalba M. RUSSO 1, Maria L. DE ANGELIS 1, Wanda P. PORRECA 1, Carlo F. PERNO 1, Stefano PASTORI 1, Paolo BRAMBILLA 2

1 Department of Laboratory Medicine, Area of Chemical Analysis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy; 2 Department of Medicine and Surgery, Milano-Bicocca University, Milan, Italy; 3 Clinical Biochemical Laboratory, Hospital of Bolzano, Bolzano, Italy; 4 Department of Cardiology, Hospital of Bolzano, Bolzano, Italy

BACKGROUND: Cardiac troponins (cTn) are the biomarkers of choice in the diagnosis of acute coronary syndrome (ACS) and increased level of cTn is a sign of myocardial injury. However, in patients with chronic kidney disease, plasma values of troponin might be higher compared to the general population, even in the absence of acute cardiac damage. Aim of this study was to determine the impact of renal function on hs-cTnT in patients with suspected ACS and to analyze how GFR affects the absolute increase in consecutive determinations of hs-cTnT.
METHODS: The population-based study included 736 subjects older than 60 years, consecutively admitted to the ED of Desio Hospital (MB) for chest pain and discharged with a diagnosis of pain of non cardiac origin (“nonspecific chest pain, ICD-9-CM code 786.50). Patients were grouped for eGFR, age and gender and hs-cTnT determinations were performed at baseline (T0) and after 3 hours (T3).
RESULTS: In females with eGFR<60 mL/min, median hs-cTnT values at T0 and T3 were significantly higher when compared to the ≥60eGFR<90 mL/min group. The same was observed in men older than 75 years. The median values of absolute difference T3-T0 (Δabs) was not affected by eGFR, regardless of age and gender.
CONCLUSIONS: The Δabs assessment could be a useful tool for evaluation of chest pain patients with kidney disease, since it is not affected by renal function.

KEY WORDS: Creatinine; Troponin; Kidney, Chest pain

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