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A more appropriate cardiac troponin T level that can predict outcomes in end-stage renal disease patients with acute coronary syndrome

Title
A more appropriate cardiac troponin T level that can predict outcomes in end-stage renal disease patients with acute coronary syndrome
Authors
Ryu D.-R.Park J.T.Chung J.H.Song E.M.Roh S.H.Lee J.-M.An H.R.Yu M.Pyun W.B.Shin G.J.Kim S.-J.Kang D.-H.Choi K.B.
Ewha Authors
신길자강덕희최규복김승정편욱범류동열유민아
SCOPUS Author ID
신길자scopus; 강덕희scopus; 최규복scopus; 김승정scopus; 편욱범scopus; 류동열scopus; 유민아scopus
Issue Date
2011
Journal Title
Yonsei Medical Journal
ISSN
0513-5796JCR Link
Citation
vol. 52, no. 4, pp. 595 - 602
Indexed
SCI; SCIE; SCOPUS; KCI WOS scopus
Abstract
Purpose: Cardiac troponin T (cTnT), a useful marker for diagnosing acute myocardial infarction (AMI) in the general population, is significantly higher than the usual cut-off value in many end-stage renal disease (ESRD) patients without clinically apparent evidence of AMI. The aim of this study was to evaluate the clinical usefulness of cTnT in ESRD patients with acute coronary syndrome (ACS). Materials and Methods: Two hundred eighty-four ESRD patients with ACS were enrolled between March 2002 and February 2008. These patients were followed until death or June 2009. Medical records were reviewed retrospectively. The cutoff value of cTnT for AMI was evaluated using a receiver operating characteristic (ROC) curve. We calculated Kaplan-Meier survival curves, and potential outcome predictors were determined by Cox proportional hazard analysis. Results: AMIs were diagnosed in 40 patients (14.1%). The area under the curve was 0.98 in the ROC curve (p<0.001; 95% CI, 0.95-1.00). The summation of sensitivity and specificity was highest at the initial cTnT value of 0.35 ng/mL (sensitivity, 0.95; specificity, 0.97). Survival analysis showed a statistically significant difference in all-cause and cardiovascular mortalities for the group with an initial cTnT ≥0.35 ng/ mL compared to the other groups. Initial serum cTnT concentration was an independent predictor for mortality. Conclusion: Because ESRD patients with an initial cTnT concentration ≥0.35 ng/mL have a poor prognosis, it is suggested that urgent diagnosis and treatment be indicated in dialysis patients with ACS when the initial cTnT levels are ≥0.35 ng/mL. © Yonsei University College of Medicine 2011.
DOI
10.3349/ymj.2011.52.4.595
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의학전문대학원 > 의학과 > Journal papers
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