Cardiac Troponin Elevations Indicate Worse Prognosis for Kidney Disease Patients

A research review from AHRQ finds that among patients with chronic kidney disease (CKD), higher levels of the protein cardiac troponin are associated with a worse prognosis for patients with and without suspected acute coronary syndrome (ACS). In particular, for dialysis patients without suspected ACS, increased troponin T or I, which measure heart enzymes, is a strong predictor of death, according to the review, “Cardiac Troponins Used as Diagnostic and Prognostic Tests in Patients With Kidney Disease.” However, there is insufficient evidence to conclude whether elevated troponin provides strong incremental predictive value over and above carefully assessed clinical risk factors for coronary artery disease and mortality. For this research to be effective, troponin assays and cutpoints need to be standardized and harmonized so that results can be pooled, compared and applied in practice, the review indicated.