The use of high-sensitivity cardiac troponin T and creatinine kinase-MB as a prognostic markers in patients with acute myocardial infarction and chronic kidney disease
Background High-sensitivity cardiac troponin T (hs-cTnT) and creatine kinase (CK)-MB are the most commonly used biomarkers for the diagnosis and prognosis of acute myocardial infarction (AMI). Chronic kidney disease (CKD) often leads to elevated hs-cTnT levels in non-AMI patients. However, studies c...
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Taylor & Francis Group
2023-12-01
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| Series: | Renal Failure |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/0886022X.2023.2220420 |
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| author | Yunxian Chen Xiwen Zhou Zhixin Chen Jue Xia Fenglei Guan Yue Li Yanrong Li Yicai Chen Yuanlin Zhao Huayun Qiu Jiarong Liang Liangqiu Tang |
| author_facet | Yunxian Chen Xiwen Zhou Zhixin Chen Jue Xia Fenglei Guan Yue Li Yanrong Li Yicai Chen Yuanlin Zhao Huayun Qiu Jiarong Liang Liangqiu Tang |
| author_sort | Yunxian Chen |
| collection | DOAJ |
| description | Background High-sensitivity cardiac troponin T (hs-cTnT) and creatine kinase (CK)-MB are the most commonly used biomarkers for the diagnosis and prognosis of acute myocardial infarction (AMI). Chronic kidney disease (CKD) often leads to elevated hs-cTnT levels in non-AMI patients. However, studies comparing the prognostic value of both hs-cTnT and CK-MB in patients with AMI and CKD are lacking.Methods We conducted a retrospective study on AMI patients diagnosed between January 2015 and October 2020. Patients were categorized based on renal function as normal or CKD. Peak hs-cTnT and CK-MB levels during hospitalization were collected, and their diagnostic value was evaluated using receiver operating characteristic (ROC) curves. The impact on in-hospital mortality was analyzed using multivariate logistic regression. The relationship between the hs-cTnT/CK-MB ratio and in-hospital death was examined using a restricted cubic spline (RCS) curve.Results The study included 5022 AMI patients, of whom 797 (15.9%) had CKD. The AUCs of Hs-cTnT and CK-MB were higher in the CKD group [0.842 (95% CI: 0.789–0.894) and 0.821 (95% CI: 0.760–0.882)] than in the normal renal function group [0.695 (95% CI: 0.604-0.790) and 0.708 (95% CI: 0.624-0.793)]. After full adjustment for all risk factors, hs-cTnT (OR, 2.82; 95% CI, 1.03–9.86; p = 0.038) and CK-MB (OR, 4.91; 95% CI, 1.54–14.68; p = 0.007) above the cutoff values were independent predictors of in-hospital mortality in patients with CKD. However, in patients with normal renal function, only CK-MB above the cutoff (OR, 2.45; 95% CI, 1.02–8.24; p = 0.046) was a predictor of in-hospital mortality, whereas hs-cTnT was not. There was an inverted V-shaped relationship between the hs-cTnT/CK-MB ratio and in-hospital mortality, with an inflection point of 19.61. The ratio within the second quartile (9.63-19.6) was an independent predictor of in-hospital mortality in patients with CKD (OR 5.3, 95% CI 1.66–16.86, p = 0.005).Conclusions Hs-cTnT independently predicted in-hospital mortality in AMI patients with CKD, whereas its predictive value was not observed in patients with normal renal function. CK-MB was an independent predictor of in-hospital mortality regardless of renal function. Moreover, the hs-cTnT/CK-MB ratio may aid in risk stratification of AMI patients with CKD. |
| format | Article |
| id | doaj-art-133cf7680e0a4d8aad6b47111468d1b3 |
| institution | OA Journals |
| issn | 0886-022X 1525-6049 |
| language | English |
| publishDate | 2023-12-01 |
| publisher | Taylor & Francis Group |
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| series | Renal Failure |
| spelling | doaj-art-133cf7680e0a4d8aad6b47111468d1b32025-08-20T02:16:11ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492023-12-0145110.1080/0886022X.2023.2220420The use of high-sensitivity cardiac troponin T and creatinine kinase-MB as a prognostic markers in patients with acute myocardial infarction and chronic kidney diseaseYunxian Chen0Xiwen Zhou1Zhixin Chen2Jue Xia3Fenglei Guan4Yue Li5Yanrong Li6Yicai Chen7Yuanlin Zhao8Huayun Qiu9Jiarong Liang10Liangqiu Tang11Department of Cardiology, Yue Bei People’s Hospital, Shantou University Medical College, Shaoguan, ChinaDepartment of Cardiology, Yue Bei People’s Hospital, Shantou University Medical College, Shaoguan, ChinaDepartment of Cardiology, Yue Bei People’s Hospital, Shantou University Medical College, Shaoguan, ChinaDepartment of Cardiology, Yue Bei People’s Hospital, Shantou University Medical College, Shaoguan, ChinaDepartment of Cardiology, Yue Bei People’s Hospital, Shantou University Medical College, Shaoguan, ChinaDepartment of Cardiology, Yue Bei People’s Hospital, Shantou University Medical College, Shaoguan, ChinaDepartment of Cardiology, Yue Bei People’s Hospital, Shantou University Medical College, Shaoguan, ChinaDepartment of Cardiology, Yue Bei People’s Hospital, Shantou University Medical College, Shaoguan, ChinaDepartment of Cardiology, Yue Bei People’s Hospital, Shantou University Medical College, Shaoguan, ChinaShaoguan College of Medicine, Shaoguan, ChinaDepartment of Cardiology, Yue Bei People’s Hospital, Shantou University Medical College, Shaoguan, ChinaDepartment of Cardiology, Yue Bei People’s Hospital, Shantou University Medical College, Shaoguan, ChinaBackground High-sensitivity cardiac troponin T (hs-cTnT) and creatine kinase (CK)-MB are the most commonly used biomarkers for the diagnosis and prognosis of acute myocardial infarction (AMI). Chronic kidney disease (CKD) often leads to elevated hs-cTnT levels in non-AMI patients. However, studies comparing the prognostic value of both hs-cTnT and CK-MB in patients with AMI and CKD are lacking.Methods We conducted a retrospective study on AMI patients diagnosed between January 2015 and October 2020. Patients were categorized based on renal function as normal or CKD. Peak hs-cTnT and CK-MB levels during hospitalization were collected, and their diagnostic value was evaluated using receiver operating characteristic (ROC) curves. The impact on in-hospital mortality was analyzed using multivariate logistic regression. The relationship between the hs-cTnT/CK-MB ratio and in-hospital death was examined using a restricted cubic spline (RCS) curve.Results The study included 5022 AMI patients, of whom 797 (15.9%) had CKD. The AUCs of Hs-cTnT and CK-MB were higher in the CKD group [0.842 (95% CI: 0.789–0.894) and 0.821 (95% CI: 0.760–0.882)] than in the normal renal function group [0.695 (95% CI: 0.604-0.790) and 0.708 (95% CI: 0.624-0.793)]. After full adjustment for all risk factors, hs-cTnT (OR, 2.82; 95% CI, 1.03–9.86; p = 0.038) and CK-MB (OR, 4.91; 95% CI, 1.54–14.68; p = 0.007) above the cutoff values were independent predictors of in-hospital mortality in patients with CKD. However, in patients with normal renal function, only CK-MB above the cutoff (OR, 2.45; 95% CI, 1.02–8.24; p = 0.046) was a predictor of in-hospital mortality, whereas hs-cTnT was not. There was an inverted V-shaped relationship between the hs-cTnT/CK-MB ratio and in-hospital mortality, with an inflection point of 19.61. The ratio within the second quartile (9.63-19.6) was an independent predictor of in-hospital mortality in patients with CKD (OR 5.3, 95% CI 1.66–16.86, p = 0.005).Conclusions Hs-cTnT independently predicted in-hospital mortality in AMI patients with CKD, whereas its predictive value was not observed in patients with normal renal function. CK-MB was an independent predictor of in-hospital mortality regardless of renal function. Moreover, the hs-cTnT/CK-MB ratio may aid in risk stratification of AMI patients with CKD.https://www.tandfonline.com/doi/10.1080/0886022X.2023.2220420High-sensitivity cardiac troponin Tcreatine kinase (CK)-MBacute myocardial infarctionchronic kidney diseaseprognosis |
| spellingShingle | Yunxian Chen Xiwen Zhou Zhixin Chen Jue Xia Fenglei Guan Yue Li Yanrong Li Yicai Chen Yuanlin Zhao Huayun Qiu Jiarong Liang Liangqiu Tang The use of high-sensitivity cardiac troponin T and creatinine kinase-MB as a prognostic markers in patients with acute myocardial infarction and chronic kidney disease Renal Failure High-sensitivity cardiac troponin T creatine kinase (CK)-MB acute myocardial infarction chronic kidney disease prognosis |
| title | The use of high-sensitivity cardiac troponin T and creatinine kinase-MB as a prognostic markers in patients with acute myocardial infarction and chronic kidney disease |
| title_full | The use of high-sensitivity cardiac troponin T and creatinine kinase-MB as a prognostic markers in patients with acute myocardial infarction and chronic kidney disease |
| title_fullStr | The use of high-sensitivity cardiac troponin T and creatinine kinase-MB as a prognostic markers in patients with acute myocardial infarction and chronic kidney disease |
| title_full_unstemmed | The use of high-sensitivity cardiac troponin T and creatinine kinase-MB as a prognostic markers in patients with acute myocardial infarction and chronic kidney disease |
| title_short | The use of high-sensitivity cardiac troponin T and creatinine kinase-MB as a prognostic markers in patients with acute myocardial infarction and chronic kidney disease |
| title_sort | use of high sensitivity cardiac troponin t and creatinine kinase mb as a prognostic markers in patients with acute myocardial infarction and chronic kidney disease |
| topic | High-sensitivity cardiac troponin T creatine kinase (CK)-MB acute myocardial infarction chronic kidney disease prognosis |
| url | https://www.tandfonline.com/doi/10.1080/0886022X.2023.2220420 |
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