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Cardiac Troponin T in Acute Coronary Syndrome with Renal Insufficiency

Department of Respiratory and Critical Care Medicine, Singapore General Hospital, Singapore

For reprint information contact: Huck Chin Chew, MMed, Tel: 65 9856 0027, Fax: 65 6462 4178, Email: chinnjing{at}pacific.net.sg, Department of Respiratory and Critical Care Medicine, Singapore General Hospital, Outram Road, Singapore 169608.

Cardiac troponin levels are frequently elevated in patients with chronic renal failure, hence diagnosis of myocardial necrosis is difficult. The prevalence of elevated serum troponin T was determined and its diagnostic value in acute coronary syndrome was assessed in patients with chronic renal insufficiency. A retrospective cross-sectional analysis was performed in 227 patients with chronic renal insufficiency and a diagnosis of unstable angina, non-ST or ST-segment elevation myocardial infarction. All patients had baseline serum troponin T levels measured at previous visits; the baseline troponin T level was raised in 53.3%. Cardiac troponin T levels did not correlate with creatinine levels, and were not affected by dialysis. Mortality after an acute coronary event was high (46.3%). Because of the elevated baseline cardiac troponin T levels, detection of acute coronary syndrome in patients with chronic renal failure requires evaluation of serial cardiac enzyme measurements and serial 12-lead electrocardiograms. Early and definitive cardiac interventions may contribute towards decreasing the mortality rate in this group of patients.