Cardiac troponin had limited diagnostic value for acute myocardial infarction in renal insufficiency: a meta-analysis

Biomark Med. 2020 Apr;14(6):481-493. doi: 10.2217/bmm-2019-0339. Epub 2020 Apr 9.


Aim: To evaluate the diagnostic efficiency of cardiac troponin (cTn) for acute myocardial infarction in renal insufficiency patients. Materials & methods: Medline, EMBASE and the CENTRAL databases were searched for eligible studies. Results: Thirteen studies were included. The sensitivity of the 99th percentiles for high-sensitivity cTn (hs-cTn) was 0.94 (95% CI: 0.87, 0.97), the specificity was 0.56 (95% CI: 0.42, 0.68). Subgroup analysis found that the sensitivity for hs-cTnT and hs-cTnI were similar, but the specificity was higher for hs-cTnI. The optimized cut-off values slightly increased the specificity, but decreased the sensitivity. Serial sampling of hs-cTn seemed to increase the diagnostic efficiency. Conclusion: The usual and optimized cut-off threshold for cTn had decreased diagnostic efficacy for acute myocardial infarction. Serial sampling seemed to increase the diagnostic efficiency.

Keywords: acute myocardial infarction; cardiac troponin; renal insufficiency; sensitivity and specificity.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Acute Disease
  • Humans
  • Myocardial Infarction / complications*
  • Myocardial Infarction / diagnosis*
  • Myocardial Infarction / metabolism
  • Myocardium / metabolism*
  • Renal Insufficiency / complications*
  • Troponin / metabolism*


  • Troponin