High-sensitivity troponin T is more susceptible than high-sensitivity troponin i to impaired renal function

摘要

We read the report by Pfortmueller et al, who showed that the diagnostic value for acute myocardial infarction (AMI) of high-sensitivity (HS) troponin T (TnT) was poor in patients with impaired renal function at emergency department (ED) admission. Because the renal metabolism of the different troponin isoforms is markedly different, we carried out a clinical investigation to establish whether renal function may influence the values of TnT and troponin I (TnT) measured with HS immunoassays in patients admitted to the ED with suspected AMI but without a final diagnosis of myocardial ischemia. The study population consisted of 48 consecutive patients admitted with chest pain to the local ED and for whom a final diagnosis of myocardial ischemia could be ruled out according to the third universal definition of AMI. Cardiac troponins were assessed at patient admission with 2 highly sensitive methods, that is, the prototype Beck-man Coulter HS-AccuTnl (Beckman Coulter, Chaska, Minnesota) and the Roche HS-TnT (Roche Diagnostics, Basel, Switzerland), which are characterized by a ninety-ninth percentile of the upper reference limit of 32 ng/L and 14 ng/L, respectively.