Incidencia de lesión miocárdica en pacientes adultos con enfermedad renal crónica evaluados en la unidad de urgencias en Hospital Regional Rafael Hernández, Chiriquí, 2023.
Incidence of myocardial injury in adult patients with chronic kidney disease evaluated in the emergency unit of the Hospital Regional Rafael Hernández, Chiriquí, 2023.
DOI:
https://doi.org/10.59722/rmcu.v3i1.1002Keywords:
High-sensitivity troponin I, chronic kidney disease, cardiac biomarkers, glomerular filtration rate, emergency medical servicesAbstract
Introduction: Interpreting high-sensitivity cardiac troponin I (hs-cTnI) in patients with chronic kidney disease (CKD) without acute coronary syndrome remains a clinical challenge. This study aims to characterize hs-cTnI levels in CKD patients without acute cardiovascular pathology.
Objective: To evaluate the distribution of hs-cTnI in CKD patients and its relationship with estimated glomerular filtration rate (eGFR), excluding structural or acute cardiac conditions.
Methods: A retrospective, cross-sectional observational study conducted at a tertiary hospital in Panama during 2023. Patients ≥18 years with CKD and no evidence of ischemia or cardiovascular disease were included. Descriptive statistics, linear and non-linear regressions, and percentile calculations were performed.
Results: A total of 99 patients were analyzed. Mean hs-cTnI was 52.6 ng/L and eGFR was 19.5 ml/min/1.73m². The 99th percentile for troponin was 80.5 ng/L (men: 84.4; women: 75.9). No significant correlations were found between eGFR and hs-cTnI in any model. hs-cTnI values increased in advanced CKD stages but with high variability.
Conclusions: In CKD patients without acute cardiovascular symptoms, hs-cTnI levels frequently exceed conventional diagnostic cutoffs. Caution is needed when interpreting these values in emergency settings. Specific cutoffs should be defined for this population.
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