SORA

Advancing, promoting and sharing knowledge of health through excellence in teaching, clinical practice and research into the prevention and treatment of illness

Troponins, Acute Coronary Syndrome and Renal Disease: From Acute Kidney Injury Through End-stage Kidney Disease

Banerjee, D; Ferrett, C; Banerjee, A (2019) Troponins, Acute Coronary Syndrome and Renal Disease: From Acute Kidney Injury Through End-stage Kidney Disease. EUROPEAN CARDIOLOGY REVIEW, 14 (3). pp. 187-190. ISSN 1758-3756 https://doi.org/10.15420/ecr.2019.28.2
SGUL Authors: Banerjee, Debasish

[img]
Preview
PDF Published Version
Available under License Creative Commons Attribution Non-commercial.

Download (111kB) | Preview

Abstract

The diagnosis of acute coronary syndromes (ACS) is heavily dependent on cardiac biomarker assays, particularly cardiac troponins. ACS, particularly non-ST segment elevation MI, are more common in patients with acute kidney injury, chronic kidney disease (CKD) and end-stage kidney disease (ESKD), are associated with worse outcomes than in patients without kidney disease and are often difficult to diagnose and treat. Hence, early accurate diagnosis of ACS in kidney disease patients is important using easily available tools, such as cardiac troponins. However, the diagnostic reliability of cardiac troponins has been suboptimal in patients with kidney disease due to possible decreased clearance of troponin with acute and chronic kidney impairment and low levels of troponin secretion due to concomitant cardiac muscle injury related to left ventricular hypertrophy, inflammation and fibrosis. This article reviews the metabolism and utility of cardiac biomarkers in patients with acute and chronic kidney diseases. Cardiac troponins are small peptides that accumulate in both acute and chronic kidney diseases due to impaired excretion. Hence, troponin concentrations rise and fall with acute kidney injury and its recovery, limiting their use in the diagnosis of ACS. Troponin concentrations are chronically elevated in CKD and ESKD, are associated with poor prognosis and decrease the sensitivity and specificity for diagnosis of ACS. Yet, the evidence indicates that the use of high-sensitivity troponins can confirm or exclude a diagnosis of ACS in the emergency room in a significant proportion of kidney disease patients; those patients in whom the results are equivocal may need longer in-hospital assessment.

Item Type: Article
Additional Information: This work is open access under the CC-BY-NC 4.0 License which allows users to copy, redistribute and make derivative works for non-commercial purposes, provided the original work is cited correctly. © Radcliffe Cardiology 2019
Keywords: Acute kidney injury, chronic kidney disease, end-stage kidney disease, acute coronary syndrome, cardiac troponin, non-ST segment elevation MI
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Journal or Publication Title: EUROPEAN CARDIOLOGY REVIEW
ISSN: 1758-3756
Dates:
DateEvent
December 2019Published
7 August 2019Accepted
Publisher License: Creative Commons: Attribution-Noncommercial 4.0
Projects:
Project IDFunderFunder ID
PG 10/71/28462British Heart Foundationhttp://dx.doi.org/10.13039/501100000274
204809/Z/16/ZWellcome Trusthttp://dx.doi.org/10.13039/100004440
Web of Science ID: WOS:000503430400012
URI: https://openaccess.sgul.ac.uk/id/eprint/111565
Publisher's version: https://doi.org/10.15420/ecr.2019.28.2

Actions (login required)

Edit Item Edit Item