A Clinical Study On Cardiac Troponin Ⅰ In Non-Acute Coronary Syndrome Patients With Chronic Kidney Disease

Objective: The aim of this study was to assess the results of troponin I (cTnI) innon-Acute Coronary Syndrome (ACS) patients with chronic kidney disease (CKD).We also examined the risk factors for elevated cTnI in non-ACS patients with CKDand whether stage5CKD modifies the associations of elevated cTnI and the riskfactors in non-ACS patients with CKD.Methods： A retrospective study was performed. We included in patients withCKD in Zhangzhou Affiliated Hospital of Fujian Medical University between Januaryof2009and December of2011, and in whom cTnI was determined. Our exclusioncriteria included1) chest pain, and2) ST segment elevation or pathologic Q waveformation in electrocardiogram (ECG). Variables included in the study were: age,gender, smoking history, diabetes mellitus, hypertension, blood pressure, congestiveheart failure, primary renal disease, determination of serum cTnI, CK-MB, serumcalcium-phosphorus product, serum C-reactive protein (CRP), serum low densitylipoprotein (LDL), serum high density lipoprotein (HDL), serum homocysteine,hemoglobin, platelet,12-lead ECG and cardiothoracic ratio determined by x-ray.According to the concentrations of cTnI, patients were divided into two groups:1)patients with normal cTnI levels (0-0.06ng/ml),2) patients with elevated cTnIlevels(>0.06ng/ml).Logistic regression models were used.Results:293non-ACS patients with CKD were included in the current study.43.34%non-ACS patients with CKD have an elevated cTnI level and5.12%have an elevatedcTnT level in MI range. In CKD patients without ACS and heart failure, only26.03%(38/146) patients have an elevated cTnT level. In adjusted analyses, age, diastolicblood pressure and congestive heart failure is associated with an elevated cTnI level innon-ACS patients with CKD. Congestive heart failure is associated with an elevated cTnI level in non-ACS patients with CKD (OR2.30,95%CI1.08,4.88, P=0.03).Stage5CKD does not modify the association of congestive heart failure and anelevated cTnI level.Conclusions:43.34%non-ACS patients with CKD and26.03%CKD patientswithout ACS and congestive heart failure have an elevated cTnI level. Congestiveheart failure is associated with an elevated cTnI level in non-ACS patients with CKD.Stage5CKD does not modify the association of congestive heart failure and anelevated cTnI level.