Open AccessEffect of hemodialysis on traditional and innovative cardiac markers
Author(s) -
Montagnana Martina,
Lippi Giuseppe,
Tessitore Nicola,
Salvagno Gian Luca,
Targher Giovanni,
Gelati Matteo,
Lupo Antonio,
Guidi Gian Cesare
Publication year - 2008
Publication title -
journal of clinical laboratory analysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.536
H-Index - 50
eISSN - 1098-2825
pISSN - 0887-8013
DOI - 10.1002/jcla.20210
Subject(s) - medicine , troponin complex , ischemia modified albumin , cardiology , acute coronary syndrome , creatine kinase , hemodialysis , troponin t , myoglobin , troponin , ischemia , myocardial ischemia , myocardial infarction , organic chemistry , chemistry
The diagnostic approach to acute coronary syndrome (ACS) is challenging in patients with impaired renal function since most serum biomarkers are commonly increased in this clinical setting. Cardiac troponin T (cTnT), creatine kinase isoenzyme MB (CK MB), myoglobin, and ischemia modified albumin (IMA), were assayed in 45 patients prehemodialysis (pre‐HD) and posthemodialysis (post‐HD), and results were adjusted for hemoconcentration. The pre‐HD values of serum IMA and cTnT were above the respective diagnostic thresholds (IMA<85 K units/L; cTnT <0.03 ng/mL) in six (13%) and 27 (60%) patients undergoing chronic HD, respectively. A significant (105.0 vs. 79.0 K units/L, P <0.0001) and variable (+38%; 95% confidence interval [CI], 12–65%) increase of serum IMA was observed post‐HD, whereas the other biomarkers significantly decreased (cTnT: 0.029 vs. 0.044 ng/mL, P =0.016; CK‐MB: 2.33 vs. 2.50 µg/L, P <0.0001; myoglobin: 128.1 vs. 148.7 µg/L, P <0.0001). Biomarkers of myocardial injury, especially cTnT and IMA, might be used in HD patients, provided that an appropriate diagnostic interpretation is guarantee, according to individual baseine value, metabolism, and time of sampling. Moreover, IMA might be reliably applied to stratify the long‐term risk of these patients, but not for diagnosing an ACS during or immediately post‐HD. J. Clin. Lab. Anal. 22:59–65, 2008. © 2008 Wiley‐Liss, Inc.