Open Access Emergency Medicine (Feb 2022)

Differential Association Between Significant Coronary Stenosis and Cardiac Troponin T Serial Algorithms in Chronic Kidney Disease Patients Diagnosed with Non-ST-Segment Elevation Acute Coronary Syndromes

  • Tangpaisarn T,
  • Srimakam N,
  • Senthong V,
  • Phungoen P,
  • Kotruchin P

Journal volume & issue
Vol. Volume 14
pp. 41 – 49

Abstract

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Thanat Tangpaisarn,1 Nirut Srimakam,1 Vichai Senthong,2 Pariwat Phungoen,1 Praew Kotruchin1 1Department of Emergency Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; 2Department of Internal Medicine, Faculty of Medicine Srinagarind Hospital, Khon Kaen University, Khon Kaen, ThailandCorrespondence: Praew KotruchinDepartment of Emergency Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand, Tel +66 65 5269 422, Email [email protected]: High-sensitivity cardiac troponin T (hs-cTnT) is recommended for diagnosing non-ST segment elevation acute coronary syndromes (NSTE-ACS). While the guidelines recommend using the 0,1-hour (hr) and 0,3-hr hs-cTnT algorithms, their efficacy has not been clearly established in chronic kidney disease (CKD) patients. We aimed to assess the differential associations between the two algorithms mentioned above with significant coronary stenosis in CKD patients.Methods: This was a retrospective cohort study. Patients aged ≥ 18 years who were diagnosed with NSTE-ACS and had undergone coronary angiogram were recruited. The differential association between significant coronary stenosis and being ruled in based on the 0,1-hr and 0,3-hr hs-cTnT algorithm was analyzed and reported.Results: There were 158 and 160 patients in the CKD and normal renal function groups. Among CKD patients, determinants of significant coronary stenosis were hypertension (OR = 2.68; 95% CI 1.10– 6.50) and being ruled in by the 0,3-hr algorithm (OR = 3.65; 95% CI 1.27– 10.52). In the normal renal function group, age (OR = 1.04; 95% CI 1.01– 1.06), male sex (OR = 2.15; 95% CI 1.09– 4.22), and being ruled in by the 0,1-hr algorithm (OR = 3.12; 95% CI 1.20– 8.10) were associated with significant coronary stenosis.Conclusion: Being ruled in according to the 0,3-hr algorithm was significantly associated with coronary stenosis in CKD patients, making this a likely algorithm of choice in these patients.Keywords: renal dysfunction, cardiac biomarkers, troponin, acute coronary syndromes, Asian

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