The Predictive and Diagnostic Value of Cystatin C and High Sensitive Troponin

Study Overview
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Brief Summary
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Our study is planning to evaluate patients with chronic kidney disease who come to the emergency department with chest pain. Estimated GFR (cisGFR) with cystatin and estimated GFR (creaGFR) with creatinine will be calculated. Symptoms, ECG and troponin values of patients will be evaluated for diagnosis of acute coronary syndrome

Detailed Description
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Our study is planning to evaluate patients with chronic kidney disease who come to the emergency department with chest pain. Estimated GFR (cisGFR) with cystatin and estimated GFR (creaGFR) with creatinine will be calculated. Symptoms, ECG and troponin values of patients will be evaluated for diagnosis of acute coronary syndrome and the final diagnosis of AMI will be adjudicated by 2 independent cardiologists.Serial troponin measurements and eGFR values will be proportioned. These values the will be evaluated and compared for patients with acute coronary syndrome(culprit lesion on conventional coronary angiography) and non-ACS ones . With these data we aim to facilitate the diagnosis of acute coronary syndrome,increase the specificity and sensitivity of cardiac troponins for the diagnosis of acute coronary syndrome of patients with chronic kidney disease, increase the utility of high sensitive troponins for patients with chronic kidney disease. Again, with these data, it is aimed to reduce the number of false negative and false positive diagnosis of acute coronary syndrome .

Official Title
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The Predictive and Diagnostic Value of Using Cystatin C and High Sensitive Troponin Level Together for Diagnosis of ACS in Patients With Chronic Kidney Disease Coming to Emergency Department With Chest Pain

Conditions
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Acute Coronary Syndrome, Chronic Kidney Diseases

Intervention / Treatment
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* Procedure: percutaneous coronary intervention


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age over 18, chronic kidney diease having chest pain or equivalent of chest pain (dyspnea, diaphoresis, syncope, nausea, vomiting) - Exclusion Criteria: STEMI, age less than 18, missing data, patients referred to or accepted from another medical facility

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| patients with acute coronary syndrome<br>patients with chronic kidney disease having chest pain with ecg, symptom or cardiac troponin levels compatible with ACS | Procedure: percutaneous coronary intervention<br>* conventional coronary angiography<br>|
| patients without acute coronary syndrome<br>patients with chronic kidney disease having chest pain with ecg, symptom or cardiac troponin levels NONcompatible with ACS | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| anticipated ACS | The role of cystatin C in diagnosis acute coronary syndrome when used with troponin in patients with chronic renal failure. | time passed until PCI (percutaneous coronary intervention) (pre-intervention) or admission to hospital | 
| exclusion of acs | exclusion of ACS according to current guidelines | time passed during emergency department visit until discharge avarage of 3-6 hours |