24 Influence of Renal Dysfunction on High-Sensitivity Cardiac Troponin I for Diagnostic Accuracy of Myocardial Infarction and Outcomes Assessment

Abstract Renal dysfunction is known to increase the risk of cardiovascular events such as acute myocardial infarction (MI). The goals of the current study were to evaluate, according to varying renal function, the diagnostic accuracy of a high-sensitivity cardiac troponin I (hs-cTnI) assay both for...

Full description

Saved in:
Bibliographic Details
Published in:American journal of clinical pathology 2018-01, Vol.149 (suppl_1), p.S176-S176
Main Authors: Gunsolus, Ian, Smith, Stephen, Herzog, Charles, Sexter, Anne, Apple, Fred
Format: Article
Language:English
Subjects:
Calcium-binding protein
Cardiovascular diseases
Dialysis
Emergency medical care
Epidermal growth factor receptors
Heart attacks
Hemodialysis
Ischemia
Medical diagnosis
Mortality
Myocardial infarction
Patients
Renal function
Renal insufficiency
Sex
Troponin
Troponin I
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Abstract Renal dysfunction is known to increase the risk of cardiovascular events such as acute myocardial infarction (MI). The goals of the current study were to evaluate, according to varying renal function, the diagnostic accuracy of a high-sensitivity cardiac troponin I (hs-cTnI) assay both for MI and for outcomes in patients presenting to the emergency department with symptoms suggestive of ischemia. Enrolled were 1555 consecutive patients who presented to the emergency department with clinical indications suggestive of MI, with at least two hs-cTnI measurements (UTROPIA; NCT02060760). hs-cTnI was measured on the Abbott ARCHITECT using sex-specific 99th percentile upper reference limits (URL: female 16 ng/L; male 34 ng/L). MI was adjudicated along universal MI guidelines. One-hundred-eighty-day mortality outcomes were determined. Renal function was defined by eGFR (mL/min/1.73m2; MDRD). Categorical variables were compared using Pearson χ-square test and continuous variables were compared using the F-test. Cox model assessed mortality with respect to both renal insufficiency and cTn together. Sensitivities (0h 68%, 3h 92%, 6h 94%) and negative predictive values (NPVs; 0h 97%, 3 and 6h >99%) were not significantly affected by renal function. However, specificities decreased with impaired renal function; ranging 90%-92% with normal renal function (eGFR ≥60; n = 1168); 68%-79% with impaired renal function (eGFR ≥30–59; n = 227); 56–60% with severely impaired renal function (eGFR
ISSN:0002-9173
1943-7722
DOI:10.1093/ajcp/aqx149.393