Diagnosis accuracy of acute myocardial infarction in patients with renal injury using high-sensitivity troponin T

  Objective  To investigate the diagnostic accuracy of high-sensitivity cardiac troponin T (hs-cTnT) in patients with acute myocardial infarction (AMI) with renal damage.

  Methods  A total of 1 934 patients with chest pain were divided into different groups based on different estimated glomerular filtration rate (eGFR). There were 689 cases in the group of eGFR ≥90 mL/(min·1.73 m²)chronic kidney disease (CKD) Ⅰ stage, 889 cases in the group of eGFR 60 to < 90 mL/(min·1.73 m²) (CKDⅡ stage), 283 cases in the group eGFR 30 to < 60 mL/(min·1.73 m²) (CKD Ⅲ stage) and 73 cases in the eGFR < 30 mL/(min·1.73 m²) group (CKD Ⅳ stage). Receiver operating characteristic (ROC) curve was used to compare the diagnostic performance between the threshold and the 99th percentile.

  Results  When eGFR < 30 mL/(min·1.73 m²), eGFR 30 to < 60 mL/(min·1.73 m²) and eGFR 60 to < 90 mL/(min·1.73 m²). Compared with the corresponding sensitivity, specificity, positive predictive value and negative predictive value of the 99th percentile, and the differences in those of the ROC determination threshold were statistically significant (P < 0.01).

  Conclusion  For AMI patients with kidney damage, the ROC threshold hs-cTnT should be combined with eGFR for accurate diagnosis.