Why the study?
Many patients with chronic kidney disease have chronically elevated cardiac troponin levels, making it difficult to determine whether acute coronary syndrome is the correct diagnosis when symptoms present.
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Serial high-sensitivity troponin testing, integrated with clinical context, is essential for diagnosing acute coronary syndrome in patients with chronic kidney disease due to the high prevalence of chronically elevated baseline troponin levels.
Many patients with chronic kidney disease have chronically elevated cardiac troponin levels, and if they present with symptoms suggesting an acute coronary syndrome, it is often difficult to determine if this is the correct diagnosis. This article briefly reviews the major challenges in diagnosing acute coronary syndrome in patients with chronic kidney disease, describes the mechanisms and prognostic significance of troponin elevation in chronic kidney disease, and provides a diagnostic algorithm to risk-stratify patients with chronic kidney disease who have troponin elevation and suspected acute coronary syndrome.
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Braghieri et al. (2023) studied this question.
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