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Correlation of Serum Creatine Kinase, Creatine Kinase-MB, and Troponin I with Cardiac Pathology in End-Stage Renal Disease Patients
S. Gîju, C. Flangea, S. Ursoniu, I. Crăciun, V. Dumitraşcu, D. Vlad, V. Ostafe, A. Chiriac
Abstract: Background: The increase of serum troponins, especially troponin I, have been reported in patients with and without coronary artery diseases. Methods: We studied 51 end stage renal disease (ESRD) patients with or without clinical myocardial infarction (MI) and correlated cardiac findings with serum creatine kinase (CK), its MB isoenzyme (CK-MB), and cardiac troponin I (cTnI). Results: There was no myocardial pathology in 11 patients. Cardiac pathologies were in five groups: scarring from previous MI or patchy ventricular fibrosis (n = 5), recent MI (n = 8), recent microinfarct (n = 8), healing MI (n = 5), degenerative myocyte changes consistent with congestive heart failure CHF; (n = 8), and other cardiac pathologies (n = 6). The median concentrations in the five groups were not significantly different for either CK or CK-MB. Compared with the no-pathology group, only the MI group was significantly different for cTnI. For patients with recent MI, 37.5%, 25% and 75%, had increased CK, CK-MB and cTnI, respectively; for CHF the percentages were 62.5%, 25% and 25% respectively. Only one patient without myocardial pathology had an increase of CK-MB, cTnI. Conclusions: All patients with increased serum CK-MB, and cTnI, had significant cardiac changes. cTnI assay appears to be a more sensitive indicator of MI and other myocardial pathologies than the CK-MB assay used in this study.
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