ArticleCirculation2018
High-Sensitivity Cardiac Troponin and the Risk Stratification of Patients With Renal Impairment Presenting With Suspected Acute Coronary Syndrome.
Article in Circulation, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01852123 (High-Sensitivity Troponin in the Evaluation of Patients With Acute Coronary Syndrome), which is not on this map. Cited by 60 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
High-Sensitivity Troponin in the Evaluation of Patients With Acute Coronary Syndrome: A Randomized Controlled Trial
Who cites it
60 citing papers in PubMed, 2 syntheses or guidelines pooled it, 101 citations in OpenAlex.
- 2022 ACC Expert Consensus Decision Pathway on the Evaluation and Disposition of Acute Chest Pain in the Emergency Department: A Report of the American College of Cardiology Solution Set Oversight Committee.Journal of the American College of Cardiology · 2022Guideline
- High-sensitivity troponin assays for early rule-out of acute myocardial infarction in people with acute chest pain: a systematic review and economic evaluation.Health technology assessment (Winchester, England) · 2021Pooled it
- Implementation of a high sensitivity cardiac troponin I assay and risk of myocardial infarction or death at five years: observational analysis of a stepped wedge, cluster randomised controlled trial.BMJ (Clinical research ed.) · 2023Trial
- Sex-Specific Thresholds of High-Sensitivity Troponin in Patients With Suspected Acute Coronary Syndrome.Journal of the American College of Cardiology · 2019Trial
- High-sensitivity troponin in the evaluation of patients with suspected acute coronary syndrome: a stepped-wedge, cluster-randomised controlled trial.Lancet (London, England) · 2018Trial
- Clinical Profile and Outcomes of Patients with Chronic Kidney Disease on Chronic Hemodialysis Hospitalized for Acute Coronary Syndrome in a Tertiary Public Hospital in the Philippines.Acta medica Philippina · 2026Article
- Article
- Association of troponin-defined myocardial injury with adverse long-term survival among patients with chronic kidney disease.PloS one · 2026Observational
- Acute kidney injury, baseline renal function, troponin, and survival after myocardial infarction.Frontiers in nephrology · 2026Article
- Performance Evaluation of the 2020 European Society of Cardiology 0-hour/1-hour Algorithm Using High-sensitivity Cardiac Troponin I for Non-ST-segment Elevation Acute Coronary Syndrome and Mortality Assessment Based on 1-year Real-world Data.Annals of laboratory medicine · 2026Article
- Validation of a 0-/2-Hour High-Sensitivity Cardiac Troponin Algorithm for Suspected Acute Coronary Syndrome in the Emergency Department.Journal of the American Heart Association · 2025Article
- Serial high-sensitivity cardiac troponin I trajectories predict cardiovascular events in hemodialysis patients.Clinical kidney journal · 2025Article
- 99th-Percentile Upper Reference Limit for the New Snibe High-Sensitivity Troponin I Assay in a Southeast Asian Population.Diagnostics (Basel, Switzerland) · 2025Article
- Associations of cardiac biomarkers with chronic kidney disease and mortality in US individuals without prevalent cardiovascular disease.Scientific reports · 2025Article
- Harnessing Artificial Intelligence for Innovation in Interventional Cardiovascular Care.Journal of the Society for Cardiovascular Angiography & Interventions · 2025Review
- Diagnosis and management of ACS in patients with ESRD on haemodialysis: a comprehensive review.The British journal of cardiology · 2025Article
- Differential prognostic value of high-sensitivity troponin T based on renal function status: insights from 14,208 ACS patients undergoing PCI.Frontiers in cardiovascular medicine · 2025Article
- Cardiac Troponins in Kidney Disease.European cardiology · 2025Review
- Comprehensive Quality Analysis of Conventional and Novel Biomarkers in Diagnosing and Predicting Prognosis of Coronary Artery Disease, Acute Coronary Syndrome, and Heart Failure, a Comprehensive Literature Review.Journal of cardiovascular translational research · 2024Review
- Kidney function-specific cut-off values of high-sensitivity cardiac troponin T for the diagnosis of acute myocardial infarction.Clinical kidney journal · 2024Article
Corrections and comments
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Authors and funding
12 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundHigh-sensitivity cardiac troponin testing may improve the risk stratification and diagnosis of myocardial infarction, but concentrations can be challenging to interpret in patients with renal impairment, and the effectiveness of testing in this group is uncertain.
methodsIn a prospective multicenter study of consecutive patients with suspected acute coronary syndrome, we evaluated the performance of high-sensitivity cardiac troponin I in those with and without renal impairment (estimated glomerular filtration rate <60mL/min/1.73m
resultsOf 4726 patients identified, 904 (19%) had renal impairment. Troponin concentrations <5 ng/L at presentation identified 17% of patients with renal impairment as low risk for the primary outcome (negative predictive value, 98.4%; 95% confidence interval [CI], 96.0%-99.7%; sensitivity 98.9%; 95%CI, 97.5%-99.9%), in comparison with 56% without renal impairment (
conclusionsIn suspected acute coronary syndrome, high-sensitivity cardiac troponin identified fewer patients with renal impairment as low risk and more as high risk, but with lower specificity for type 1 myocardial infarction. Irrespective of diagnosis, patients with renal impairment and elevated cardiac troponin concentrations had a 2-fold greater risk of a major cardiac event than those with normal renal function, and should be considered for further investigation and treatment. CLINICAL
trial registrationURL: https://www.clinicaltrials.gov. Unique identifier: NCT01852123.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.