Cardiac troponins in renal failure – time for an optimistic consensus?

Authors: Buhaescu, I.¹; Izzedine, H.²; Covic, A.¹

Source: International Journal of Clinical Practice, Volume 59, Number 11, November 2005 , pp. 1317-1325(9)

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Abstract:

Summary

Elevated cardiac troponin concentrations are now accepted as the gold standard biochemical markers for the diagnosis of myocardial damage in patients with unstable coronary syndromes, having also a demonstrated value in early risk stratification and in adopting different therapeutic strategies. The specificity and sensitivity of cardiac troponins for diagnosis of acute coronary diseases in renal failure have been a point of confusion over the past decade, mainly because of moderate elevations of these cardiac biomarkers, commonly observed in patients with chronic renal dysfunction and without any significant myocardial damage. This review discusses the cardiac troponins, their biochemistry, their currently accepted cut-off values and their real significance in chronic renal failure (CRF), concluding that troponins maintain their diagnostic and prognostic values in patients with CRF, being predictive not only of cardiovascular mortality but also of general mortality in this patient group.

Keywords: Acute coronary syndromes; cardiac troponins; chronic renal failure; chronic renal insufficiency; end-stage renal disease; myocardial damage

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1368-5031.2005.00693.x

Affiliations: 1: Parhon University Hospital, Iasi, Romania, Nephrology Unit, 2: Pitie Salpetriere Hospital, Paris, France

Publication date: 2005-11-01