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High-Sensitivity Cardiac Troponin Concentrations in Patients with Chest Discomfort: Is It the Heart or the Kidneys As Well?

Author

Listed:
  • Eline P M Cardinaels
  • Sibel Altintas
  • Mathijs O Versteylen
  • Ivo A Joosen
  • Laurens-Jan C Jellema
  • Joachim E Wildberger
  • Marco Das
  • Harry J Crijns
  • Otto Bekers
  • Marja P van Dieijen-Visser
  • Bastiaan L Kietselaer
  • Alma M A Mingels

Abstract

Background: High-sensitivity cardiac troponins (hs-cTn) are the preferred biomarkers to detect myocardial injury, making them promising risk-stratifying tools for patients with symptoms of chest pain. However, circulating hs-cTn are also elevated in other conditions like renal dysfunction, complicating appropriate interpretation of low-level hs-cTn concentrations. Methods: A cross-sectional analysis was performed in 1864 patients with symptoms of chest discomfort from the cardiology outpatient department who underwent cardiac computed tomographic angiography (CCTA). Serum samples were analyzed using hs-cTnT and hs-cTnI assays. Renal function was measured by the estimated glomerular filtration rate (eGFR), established from serum creatinine and cystatin C. On follow-up, the incidence of adverse events was assessed. Results: Median hs-cTnT and hs-cTnI concentrations were 7.2(5.8–9.2) ng/L and 2.6(1.8–4.1) ng/L, respectively. Multivariable regression analysis revealed that both assay results were more strongly associated with eGFR (hs-cTnT:stβ:-0.290;hs-cTnI:stβ:-0.222) than with cardiac imaging parameters, such as coronary calcium score, CCTA plaque severity score and left ventricular mass (all p

Suggested Citation

  • Eline P M Cardinaels & Sibel Altintas & Mathijs O Versteylen & Ivo A Joosen & Laurens-Jan C Jellema & Joachim E Wildberger & Marco Das & Harry J Crijns & Otto Bekers & Marja P van Dieijen-Visser & Bas, 2016. "High-Sensitivity Cardiac Troponin Concentrations in Patients with Chest Discomfort: Is It the Heart or the Kidneys As Well?," PLOS ONE, Public Library of Science, vol. 11(4), pages 1-14, April.
    • Handle: RePEc:plo:pone00:0153300
    DOI: 10.1371/journal.pone.0153300
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