Abstract

FLORES-SOLIS, Larry M.; HERNANDEZ-DOMINGUEZ, Juan L.; OTERO-GONZALEZ, Alfonso  and  GONZALEZ-JUANATEY, José R.. Cardiac troponin I and creatine kinase MB isoenzyme in patients with chronic renal failure. Nefrología (Madr.) [online]. 2012, vol.32, n.6, pp.809-818. ISSN 1989-2284.  https://dx.doi.org/10.3265/Nefrologia.pre2012.Jul.10986.

Objective: The aim of our study was to evaluate cut-off values for acute the cardiac biomarkers cardiac troponin I (cTnI) and creatine kinase MB isoenzyme (CK-MB) in patients with chronic renal failure (CRF) different to the cut-off values proposed by the manufacturers and frequently used at the laboratory. Method: We performed a prospective study in patients with CRF with a glomerular filtration rate estimated by the MDRD-4 equation <60mL/min admitted with suspected acute coronary syndrome (ACS) by history, physical examination, and electrocardiography. cTnI and CK-MB measurements were assessed at admission and six months later by using two different analytical methods (for cTnI: Access^® and Vidas^® analysers, and for CK-MB: Access^® and Vitros^® analysers). Results: During the study period, 484 patients with CRF and suspected ACS were included. ACS was diagnosed in 12% of patients (58/484), while we finded other cardiac pathologies (OCP) in 29% of patients (140/484) and other non-cardiac pathologies (ONCP) in 59% of patients (286/484). For cTnI of the Access^® analyser with the usual cut-off value (≥0.5ng/mL), the sensitivity was 43% and specificity was 94%, while for the proposed cut-off value (≥0.11ng/mL), the values were 68% and 83%, respectively. For cTnI assessed using the Vidas^® analyser with the usual cut-off value (≥0.11ng/mL), sensitivity was 64% and specificity was 87%, while for the proposed cut-off value (≥0.06ng/mL), the values were 75% and 79%, respectively. The sensitivity and specificity for both CK-MB were lower compared with cTnI. Conclusion: The cut-off values proposed in this study for both cTnI in patients with CRF (stage 3 to 5) to diagnose ACS are significantly different from that of the general population.

Keywords : Cardiac troponin I; Creatine kinase MB; Chronic renal failure.

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