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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.

Ryu DR, Park JT, Chung JH, Song EM, Roh SH, Lee JM, An HR, Yu M, Pyun WB, Shin GJ, Kim SJ, Kang DH, Choi KB - Yonsei Med. J. (2011)

Bottom Line: We calculated Kaplan-Meier survival curves, and potential outcome predictors were determined by Cox proportional hazard analysis.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.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, School of Medicine, Ewha Womans University, 911-1 Mok-dong, Yangcheon-gu, Seoul 158-710, Korea.

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 cut-off 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.

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Related in: MedlinePlus

Receiver operator characteristic (ROC) curve of cardiac troponin T (cTnT) for diagnosing acute myocardial infarction. The area under the curve (AUC) was 0.98 (p<0.001; 95% CI, 0.95-1.00). The cTnT value of 0.35 ng/mL offers the best overall sensitivity and specificity; the sensitivity was 0.95 and the specificity was 0.97.
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Figure 1: Receiver operator characteristic (ROC) curve of cardiac troponin T (cTnT) for diagnosing acute myocardial infarction. The area under the curve (AUC) was 0.98 (p<0.001; 95% CI, 0.95-1.00). The cTnT value of 0.35 ng/mL offers the best overall sensitivity and specificity; the sensitivity was 0.95 and the specificity was 0.97.

Mentions: The ROC curve of cTnT for AMIs is shown in Fig. 1. The area under the curve (AUC) 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; the sensitivity was 0.95 and the specificity was 0.97 (Table 2).


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

Ryu DR, Park JT, Chung JH, Song EM, Roh SH, Lee JM, An HR, Yu M, Pyun WB, Shin GJ, Kim SJ, Kang DH, Choi KB - Yonsei Med. J. (2011)

Receiver operator characteristic (ROC) curve of cardiac troponin T (cTnT) for diagnosing acute myocardial infarction. The area under the curve (AUC) was 0.98 (p<0.001; 95% CI, 0.95-1.00). The cTnT value of 0.35 ng/mL offers the best overall sensitivity and specificity; the sensitivity was 0.95 and the specificity was 0.97.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3104442&req=5

Figure 1: Receiver operator characteristic (ROC) curve of cardiac troponin T (cTnT) for diagnosing acute myocardial infarction. The area under the curve (AUC) was 0.98 (p<0.001; 95% CI, 0.95-1.00). The cTnT value of 0.35 ng/mL offers the best overall sensitivity and specificity; the sensitivity was 0.95 and the specificity was 0.97.
Mentions: The ROC curve of cTnT for AMIs is shown in Fig. 1. The area under the curve (AUC) 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; the sensitivity was 0.95 and the specificity was 0.97 (Table 2).

Bottom Line: We calculated Kaplan-Meier survival curves, and potential outcome predictors were determined by Cox proportional hazard analysis.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.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, School of Medicine, Ewha Womans University, 911-1 Mok-dong, Yangcheon-gu, Seoul 158-710, Korea.

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 cut-off 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.

Show MeSH
Related in: MedlinePlus