Cardiac troponins in renal insufficiency: Review and clinical implications

Benjamin J. Freda, W. H.Wilson Tang, Frederick Van Lente, W. Franklin Peacock, Gary S. Francis

Research output: Contribution to journalReview articlepeer-review

327 Scopus citations

Abstract

Patients with renal insufficiency may have increased serum troponins even in the absence of clinically suspected acute myocardial ischemia. While cardiovascular disease is the most common cause of death in patients with renal failure, we are just beginning to understand the clinical meaning of serum troponin elevations. Serum troponin T is increased more frequently than troponin I in patients with renal failure, leading clinicians to question its specificity for the diagnosis of myocardial infarction. Many large-scale trials demonstrating the utility of serum troponins in predicting adverse events and in guiding therapy and intervention in acute coronary syndromes have excluded patients with renal failure. Despite persistent uncertainty about the mechanism of elevated serum troponins in patients with reduced renal function, data from smaller groups of renal failure patients have suggested that troponin elevations are associated with added risk, including an increase in mortality. It is possible that increases in serum troponin from baseline in patients with renal insufficiency admitted to hospital with acute coronary syndrome may signify myocardial necrosis. Further studies are needed to clarify this hypothesis.

Original languageEnglish (US)
Pages (from-to)2065-2071
Number of pages7
JournalJournal of the American College of Cardiology
Volume40
Issue number12
DOIs
StatePublished - Dec 18 2002

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