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Vol. 103, No. 4, 2006
Issue release date: July 2006
Section title: Original Paper
Nephron Clin Pract 2006;103:c129–c136
(DOI:10.1159/000092909)

Troponin I Testing in Dialysis Patients Presenting to the Emergency Room: Does Troponin I Predict the 30-Day Outcome?

Bueti J. · Krahn J. · Karpinski M. · Bohm C. · Fine A. · Rigatto C.
Section of Nephrology, St. Boniface General Hospital, Winnipeg, Canada

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: 6/2/2005
Accepted: 12/15/2005
Published online: 4/24/2006
Issue release date: July 2006

Number of Print Pages: 1
Number of Figures: 3
Number of Tables: 6

ISSN: (Print)
eISSN: 1660-2110 (Online)

For additional information: http://www.karger.com/NEC

Abstract

Background: Troponins are often measured in acutely ill chronic dialysis patients admitted to the emergency room, irrespective of their clinical presentation. The significance of an elevated troponin level in this setting is unclear. Methods: We identified all chronic dialysis patients presenting over 1 year to a tertiary care hospital emergency room who also had at least one cardiac troponin I (cTnI) level determination. We evaluated presenting complaints, risk factors for cardiac disease, cTnI levels, and major cardiac events (MCE; occurrence of cardiovascular death, myocardial infarction, de novo heart failure, or coronary revascularization) within 30 days by chart review in 149 patients (79 on hemodialysis, 70 on peritoneal dialysis). Results: Chest pain was documented in only 29% of the patients. Twenty-two patients (15%) experienced an MCE. The incidence of an MCE was the same in patients with and without chest pain. A cTnI level >0.1 ng/l was a significant predictor of an MCE (odds ratio 15.2, 95% confidence interval CI 5.26, 43.6). The likelihood ratios for MCEs were 0.32 (CI 0.16, 0.63) for a cTnI level <0.1 ng/l, 0.72 (CI 0.09, 5.5) for cTnI concentrations 0.1–0.3 ng/l, 7.8 (CI 4.2, 15) for a cTnI level >0.3, and 11.7 (CI 4.4, 31) for a cTnI concentration >2.0 ng/l. Conclusion: In acutely ill chronic dialysis patients presenting to a hospital emergency room, an elevated cTnI level indicates an increased 30-day cardiac risk, regardless of their clinical presentation.

© 2006 S. Karger AG, Basel


  

Author Contacts

Dr. Claudio Rigatto
Section of Nephrology
St. Boniface General Hospital, 409 Tache Avenue
Winnipeg, Man. R2H 2A6 (Canada)
Tel. +1 204 237 2613, Fax +1 204 233 2770, E-Mail crigatto@sbgh.mb.ca

  

Article Information

Received: June 2, 2005
Accepted: December 15, 2005
Published online: April 24, 2006
Number of Print Pages : 8
Number of Figures : 3, Number of Tables : 6, Number of References : 28

  

Publication Details

Nephron Clinical Practice

Vol. 103, No. 4, Year 2006 (Cover Date: July 2006)

Journal Editor: Powis, S.H. (London)
ISSN: 1660–2110 (print), 1660–2110 (Online)

For additional information: http://www.karger.com/NEC


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: 6/2/2005
Accepted: 12/15/2005
Published online: 4/24/2006
Issue release date: July 2006

Number of Print Pages: 1
Number of Figures: 3
Number of Tables: 6

ISSN: (Print)
eISSN: 1660-2110 (Online)

For additional information: http://www.karger.com/NEC


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