Troponina I cardíaca y creatina cinasa MB en pacientes con insuficiencia renal crónica

objective: the aim of our study was to evaluate cut-off values for acute the cardiac biomarkers cardiac troponin i (ctni) and creatine kinase mb isoenzyme (ck-mb) in patients with chronic renal failure (crf) different to the cut-off values proposed by the manufacturers and frequently used at the laboratory. method: we performed a prospective study in patients with crf with a glomerular filtration rate estimated by the mdrd-4 equation <60ml/min admitted with suspected acute coronary syndrome (acs) by history, physical examination, and electrocardiography. ctni and ck-mb measurements were assessed at admission and six months later by using two different analytical methods (for ctni: access？ and vidas？ analysers, and for ck-mb: access？ and vitros？ analysers). results: during the study period, 484 patients with crf and suspected acs were included. acs was diagnosed in 12% of patients (58/484), while we finded other cardiac pathologies (ocp) in 29% of patients (140/484) and other non-cardiac pathologies (oncp) in 59% of patients (286/484). for ctni of the access？ analyser with the usual cut-off value (≥0.5ng/ml), the sensitivity was 43% and specificity was 94%, while for the proposed cut-off value (≥0.11ng/ml), the values were 68% and 83%, respectively. for ctni assessed using the vidas？ analyser with the usual cut-off value (≥0.11ng/ml), sensitivity was 64% and specificity was 87%, while for the proposed cut-off value (≥0.06ng/ml), the values were 75% and 79%, respectively. the sensitivity and specificity for both ck-mb were lower compared with ctni. conclusion: the cut-off values proposed in this study for both ctni in patients with crf (stage 3 to 5) to diagnose acs are significantly different from that of the general population.