THRESHOLD OF CARDIAC TROPONIN VALUES IN THE DIAGNOSIS OF ACUTE CORONARY SYNDROME IN PATIENTS WITH RENAL INSUFFICIENCY

• Grant number: 23/08220-1
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: September 01, 2023
• End date: August 31, 2024
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Julio Flávio Meirelles Marchini
• Grantee: Murilo Ferreira Velo
• Host Institution: Hospital das Clínicas da Faculdade de Medicina da USP (HCFMUSP). Secretaria da Saúde (São Paulo - Estado). São Paulo , SP, Brazil

Abstract

Cardiac troponin has high sensitivity and specificity in the diagnosis of acute coronary syndrome. However, in patients whose renal function is compromised, the reference values for troponin associated with normality vary, in a way that is not well understood in the literature. Troponin or its detectable metabolites in troponin assays may have renal elimination, which is compromised in patients with renal failure.This is a single-center, retrospective study. Data collected from the databases of hospital systems at the Hospital das Clínicas of the Faculty of Medicine of the University of São Paulo (HCFMUSP). The sample of interest is composed of patients admitted to the emergency room with suspected ACS, who were collected as troponins. The kind will be separated into three groups: patients with normal renal function, non-dialysis chronic renal failure and dialysis patients. The primary endpoint is acute coronary syndrome, whether due to a diagnosis of heart attack, need for revascularization, or death within 30 days of admission. The data will leverage and the ROC curve will be used to determine the high-sensitivity troponin values that drive a negative predictive value, positive predictive value, and better accuracy for diagnosing ACS in each of the patient groups.The working hypothesis is that there are and that it is possible to identify troponin thresholds with clinical importance for the diagnosis of ACS in patients with different degrees of renal failure, up to those on dialysis.