SHM Converge Scientific Abstract ePoster Gallery-Impact of Elevated Troponin T in Hospitalized Patients With Esrd

Pdf Summary

This retrospective single-center study examined hospitalized patients with end-stage renal disease (ESRD) who had elevated troponin T, aiming to understand how troponin changes relate to myocardial infarction (MI) classification, readmission, and mortality. Because ESRD patients often have chronically elevated troponin and atypical MI symptoms, diagnosis is difficult.<br /><br />From 280 eligible patients, 251 were included after excluding those without serial troponin levels. Most were classified as type 2 MI (241 patients), while only 10 had type 1 MI. The median troponin rise was much larger in type 1 MI than type 2 MI (180.56% vs 44.28%). However, many type 2 MI patients were still treated with acute coronary syndrome protocols, suggesting uncertainty in clinical interpretation.<br /><br />Among 61 patients with known coronary artery disease (CAD), mortality was significantly higher than in those without CAD. Regardless of MI type, mortality was also higher in patients with heart failure with preserved ejection fraction (HFpEF) and CAD. Thirty-day readmission rates were similar between type 1 and type 2 MI. Overall mortality was somewhat higher in type 1 MI, but this difference was not statistically significant.<br /><br />Kaplan-Meier analysis showed slightly higher 1-year mortality in type 1 MI and in patients with troponin elevation of 20% or more, but again these differences were not significant.<br /><br />The authors conclude that MI diagnosis and treatment in ESRD patients with elevated troponin remain unclear, and that the role of a 20% troponin change needs further study. They suggest randomized trials to determine whether diagnostic or therapeutic coronary interventions improve outcomes in ESRD patients, especially those with CAD or heart failure.

Asset Subtitle

Jorge Gutierrez

Meta Tag

Author List Abdul Wahab, Afsheen Afzal, Alberto Romero Garcia, Chee Yao Lim, Drashti N. Desai, Harsh Sura, Jaha Oh, Jorge Gutierrez, Kenneth Johan, Maria Angela Matabang, Rabia Ashraf, Saher Shiza, Shefali Pati, Vidya Menon

Category Research

Concept Myocardial Infarction

Concept End-stage Kidney Disease

Concept Cardiac Troponin T

Concept Percent Change

Concept Acute Myocardial Injury

Distinguished Non-Finalist

Presenter Organization Lincoln Medical and Mental Health Center

Presenting Author Jorge Gutierrez

Track Translating Research into Practice

Keywords

end-stage renal disease

troponin T

myocardial infarction

type 1 MI

type 2 MI

coronary artery disease

heart failure with preserved ejection fraction

mortality

readmission

troponin change

Myocardial Infarction

End-stage Kidney Disease

Cardiac Troponin T

Percent Change

Acute Myocardial Injury