Key result
Elevated troponin I accurately predicts CAD in advanced CKD with ~0.95 AUC.
Why the study?
Patients with CKD have an increased risk of CAD, but interpreting cardiac biomarkers is challenging because reduced renal clearance can elevate baseline levels. The diagnostic utility of Troponin I and CK-MB for detecting CAD in CKD Stage IV and V required evaluation.
Does Troponin I and CK-MB measurement accurately detect coronary artery disease in patients with CKD Stage IV and V?
Cross-Sectional (n=90)
No
Does Troponin I and CK-MB measurement accurately detect coronary artery disease in patients with CKD Stage IV and V?
In patients with Stage IV and V CKD, Troponin I demonstrates high diagnostic accuracy (AUC 0.946 at cut-off >0.15 ng/mL) for detecting coronary artery disease, whereas CK-MB shows no significant discriminatory value.
Answers are grounded in this paper and cite their sources.
Troponin I may aid CAD detection in advanced CKD but should not yet change practice; leaves open prospective validation before clinical adoption.
Background: Chronic kidney disease (CKD) is associated with a markedly increased risk of cardiovascular disease, particularly coronary artery disease (CAD).Interpretation of cardiac biomarkers in CKD is challenging because reduced renal clearance may result in elevated baseline levels.This study evaluated the utility of Troponin I (Trop I) and Creatine Kinase-MB (CK-MB) in detecting CAD among patients with CKD Stage IV and V. Methods: A cross-sectional study was conducted in the Departments of General Medicine, Cardiology, and Nephrology at Vydehi Institute of Medical Sciences and Research Centre from March 2023 to August 2024.Ninety patients aged >18 years with CKD Stage IV or V were enrolled.Demographic details, clinical history, laboratory investigations, serum creatinine, estimated glomerular filtration rate (eGFR), Troponin I, CK-MB, electrocardiography, and two-dimensional echocardiography findings were recorded.Comparisons were made between patients with and without CAD.Receiver operating characteristic (ROC) analysis was performed to assess the diagnostic performance of Troponin I. Results:The mean age of participants was 58.93 ± 12.00 years, and 71.1% were males.CAD was present in 28 (31.1%)patients.Serum creatinine and eGFR were comparable between CAD and non-CAD groups (p>0.05).Mean Troponin I levels were significantly higher in patients with CAD than those without CAD (1.10 ± 1.18 vs. 0.04 ± 0.05 ng/mL; p<0.001).In contrast, CK-MB levels did not differ significantly between groups (4.71 ± 6.47 vs. 3.73 ± 3.44 ng/mL; p=0.352).ROC analysis demonstrated excellent diagnostic performance of Troponin I for predicting CAD, with an AUC of 0.946, sensitivity of 89.29%, specificity of 98.39%, and an optimal cut-off value of >0.15 ng/mL.Conclusion: Troponin I is a reliable and clinically useful biomarker for detecting CAD in patients with CKD Stage IV and V, whereas CK-MB has limited diagnostic value.Troponin I may aid cardiovascular risk stratification when interpreted alongside clinical and imaging findings.
No takes yet. Share an insight, caveat, or question.
A 2026 study conducted a cross-sectional in Chronic Kidney Disease Stage IV and V (n=90). Coronary artery disease (evaluated via Troponin I and CK-MB levels) vs. No coronary artery disease was evaluated on Mean Troponin I level (ng/mL) and diagnostic performance (AUC) for detecting coronary artery disease (AUC 0.946, 95% CI 0.878-0.983, p=<0.001). Troponin I levels were significantly higher in CKD Stage IV–V patients with CAD than without (1.10 vs 0.04 ng/mL, p<0.001), predicting CAD with an AUC of 0.946.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: