Serum Troponin I Level for Diagnosis of Acute Coronary Syndrome in Patients with Chronic Kidney Disease

Iran J Kidney Dis. 2016 Jan;10(1):11-6.


Introduction: Myocardial infarction is a common cause of mortality in patients with chronic kidney disease (CKD). Since troponins I and T levels rise in CKD patients without any myocardial cause, diagnostic value of cardiac troponins is not high in these patients. This study aimed to evaluate the value of troponin I and other cardiac biomarkers to differentiate acute coronary syndrome in CKD patients.

Materials and methods: In this cross-sectional study, patients with stage 3 to 5 of CKD with typical chest pain were enrolled. Troponins I and T and other biomarkers were measured, and angiography was carried out in these patients. Cardiac biomarkers and other variables were evaluated in patients and compared with angiography results.

Results: Ninety CKD patients with a mean age of 61.67 ± 15.87 years were enrolled. Angiography results were normal in 48.9% of the patients, while it showed single-vessel disease in 14.5%, two-vessel disease in 23.3%, and three-vessel disease in 13.3%. Serum creatinine level, glomerular filtration rate, troponin I level, and creatine kinase level were not significantly different in patients with normal and abnormal angiography findings. The serum troponin I, creatine kinase, and creatine kinase-myocardial bound levels had no significant diagnostic values to differentiate abnormal angiography in CKD patients.

Conclusions: Serum levels of cardiac troponin I and creatine kinase-myocardial bound were not suitable to diagnose ACS in CKD patients (stages 3 to 5); therefore, we suggest using other diagnostic attempts in similar conditions. More evaluation is needed to confirm these findings.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Coronary Syndrome / blood*
  • Acute Coronary Syndrome / complications
  • Acute Coronary Syndrome / diagnosis*
  • Adult
  • Aged
  • Angiography
  • Biomarkers / blood
  • Chest Pain / etiology
  • Creatine Kinase, MB Form / blood
  • Creatinine / blood
  • Cross-Sectional Studies
  • Female
  • Glomerular Filtration Rate
  • Humans
  • Kidney Failure, Chronic / complications*
  • Kidney Failure, Chronic / physiopathology
  • Male
  • Middle Aged
  • ROC Curve
  • Troponin I / blood*
  • Troponin T / blood


  • Biomarkers
  • Troponin I
  • Troponin T
  • Creatinine
  • Creatine Kinase, MB Form