Clearing Up Cardiorenal Confusion
Authors: William G. Kussmaul, Ashwini R. Sehgal
Journal: Annals of Internal Medicine (2014)

Editorials7 October 2014Clearing Up Cardiorenal ConfusionWilliam G. Kussmaul III, MD and Ashwini R. Sehgal, MDWilliam G. Kussmaul III, MDFrom Hahnemann University Hospital, Philadelphia, Pennsylvania, and Case Western Reserve University, Cleveland, Ohio.Search for more papers by this author and Ashwini R. Sehgal, MDFrom Hahnemann University Hospital, Philadelphia, Pennsylvania, and Case Western Reserve University, Cleveland, Ohio.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M14-1630 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Timely diagnosis of cardiac injury is necessary to limit the extent of myocardial damage and to prevent and treat complications. Because cardiac injury involves disruption of myocytes, the diagnosis of acute myocardial infarction has relied on the measurement of released cellular components and the presence of symptoms and electrocardiographic abnormalities. Previously used markers, such as creatine kinase, myoglobin, and lactate dehydrogenase, are also present in some noncardiac tissues, which limits their sensitivity and specificity. In contrast, cardiac troponins (troponin I and troponin T) are proteins that regulate muscle contraction and are found almost exclusively in the heart. Therefore, they are ...References1. Christenson E, Christenson RH. The role of cardiac biomarkers in the diagnosis and management of patients presenting with suspected acute coronary syndrome. Ann Lab Med. 2013;33:309-18. [PMID: 24003420] doi:10.3343/alm.2013.33.5.309 CrossrefMedlineGoogle Scholar2. Apple FS, Murakami MM, Pearce LA, Herzog CA. 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Latini R, Masson S, Anand IS, Missov E, Carlson M, Vago T, et al; Val-HeFT Investigators. Prognostic value of very low plasma concentrations of troponin T in patients with stable chronic heart failure. Circulation. 2007;116:1242-9. [PMID: 17698733] CrossrefMedlineGoogle Scholar7. Michos ED, Wilson LM, Yeh HC, Berger Z, Suarez-Cuervo C, Stacy SR, et al. Prognostic value of cardiac troponin in patients with chronic kidney disease without suspected acute coronary syndrome. A systematic review and meta-analysis. Ann Intern Med. 2014;161:491-501. doi:10.7326/M14-0743 LinkGoogle Scholar8. Stacy SR, Suarez-Cuervo C, Berger Z, Wilson LM, Yeh HC, Bass EB, et al. Role of troponin in patients with chronic kidney disease and suspected acute coronary syndrome. A systematic review. Ann Intern Med. 2014;161:502-12. doi:10.7326/M14-0746 LinkGoogle Scholar9. Jacobs LH, van de Kerkhof J, Mingels AM, Kleijnen VW, van der Sande FM, Wodzig WK, et al. Haemodialysis patients longitudinally assessed by highly sensitive cardiac troponin T and commercial cardiac troponin T and cardiac troponin I assays. Ann Clin Biochem. 2009;46:283-90. [PMID: 19454537] doi:10.1258/acb.2009.008197 CrossrefMedlineGoogle Scholar10. Jha V, Garcia-Garcia G, Iseki K, Li Z, Naicker S, Plattner B, et al. Chronic kidney disease: global dimension and perspectives. Lancet. 2013;382:260-72. [PMID: 23727169] doi:10.1016/S0140-6736(13)60687-X CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Hahnemann University Hospital, Philadelphia, Pennsylvania, and Case Western Reserve University, Cleveland, Ohio.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M14-1630.Corresponding Author: William G. Kussmaul III, MD, Hahnemann University Hospital, 230 North Broad Street, Room 1536, South Tower, Philadelphia, PA 19102.This article was published online first at www.annals.org on 12 August 2014.Current Author Addresses: Dr. Kussmaul: Hahnemann University Hospital, 216 North Broad Street, Suite 201, Philadelphia, PA 19102.Dr. Sehgal: Case Western Reserve University, 2500 MetroHealth Drive, Rammelkamp 213, Cleveland, OH 44109. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoPrognostic Value of Cardiac Troponin in Patients With Chronic Kidney Disease Without Suspected Acute Coronary Syndrome Erin D. Michos , Lisa M. Wilson , Hsin-Chieh Yeh , Zackary Berger , Catalina Suarez-Cuervo , Sylvie R. Stacy , and Eric B. Bass Role of Troponin in Patients With Chronic Kidney Disease and Suspected Acute Coronary Syndrome Sylvie R. Stacy , Catalina Suarez-Cuervo , Zackary Berger , Lisa M. Wilson , Hsin-Chieh Yeh , Eric B. Bass , and Erin D. Michos Prognostic Value of Cardiac Troponin in Patients With Chronic Kidney Disease Without Suspected Acute Coronary Syndrome Erin D. Michos , Lisa M. Wilson , Hsin-Chieh Yeh , Zackary Berger , Catalina Suarez-Cuervo , Sylvie R. Stacy , and Eric B. Bass Role of Troponin in Patients With Chronic Kidney Disease and Suspected Acute Coronary Syndrome Sylvie R. Stacy , Catalina Suarez-Cuervo , Zackary Berger , Lisa M. Wilson , Hsin-Chieh Yeh , Eric B. Bass , and Erin D. Michos Metrics 7 October 2014Volume 161, Issue 7Page: 528-529KeywordsHeart diseasesHeart failureMedical dialysisMyocardial infarctionRenal failureSpecificitySystematic reviewsTroponin ePublished: 7 October 2014 Issue Published: 7 October 2014 Copyright & PermissionsCopyright © 2014 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...