Journal Article

Impact of kidney function on plasma troponin concentrations after coronary artery bypass grafting

Regine Wießner, Kurt Hannemann-Pohl, Reinhard Ziebig, Herko Grubitzsch, Berthold Hocher, Ortrud Vargas-Hein, Andreas Lun, Ingolf Schimke and Lutz Liefeldt

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 23, issue 1, pages 231-238
Published in print January 2008 | ISSN: 0931-0509
Published online September 2007 | e-ISSN: 1460-2385 | DOI: http://dx.doi.org/10.1093/ndt/gfm513
Impact of kidney function on plasma troponin concentrations after coronary artery bypass grafting

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Background. To date, there have been no studies reliably showing an influence of the kidney on the concentration of troponins. We therefore analysed the concentration curves in patients after coronary artery bypass grafting (CABG) according to their dependence on renal function.

Methods. We determined cardiac troponin I (cTnI), cardiac troponin T (cTnT) and creatinine in plasma in 28 patients after CABG. Discrimination into patients with normal (n = 13) and impaired (n = 15) renal function was based on creatinine clearance (Crea-Clear). The curves for cTnI and cTnT, as recorded by post-operative measurements, were approximated using mathematical functions. The curve parameters peak maximum (Pmax), peak position (Ppos), half-height breadth (HHB) and area under the curve (AUC) were established after this. Assuming an exponential function, the half-life (t1/2) of cTnI was determined from the declining part of the curve.

Results. For both, cTnI and cTnT, significant differences in Pmax, Ppos, HHB and AUC were detected after curve approximation. The t1/2 values of cTnI were 25.1 h (22.0–35.3) for the group with normal renal function and 38.4 h (35.9–51.9) for patients with impaired renal function (P = 0.001). An influence of diabetes mellitus (Dm), renal replacement therapy or the age of the patients could not be verified.

Conclusion. The results of this study clearly demonstrate that kidney function has an impact on plasma troponin concentrations. In everyday clinical practice this has to be considered when interpreting elevated plasma troponin concentration in patients with impaired renal function.

Keywords: coronary artery bypass grafting; curve approximation; half-life; troponin I; troponin T; renal function

Journal Article.  4241 words.  Illustrated.

Subjects: Nephrology

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