Which Troponin Marker Results in Relatively High Assay’s?
David J Sasso Jr, BSN, RN
Rhode Island College
Dr. Creamer
Professional Role Development
N 503
12 March 2015
Abstract
The clinical problem of chronic kidney disease is one that affects approximately twenty six million Americans annually. The signs and symptoms of this disease are common and most times nonspecific meaning they can be manifested by other diseases. The complications this disease causes are enormous and intimidating, so it is extremely imperative when we are assessing our patients for potential complications, we interpret the lab results accordingly. A review of research provides a different interpretation of two different types of troponin levels from patients …show more content…
As with any other medical condition, we know that early detection is key to prevent disease progression to kidney failure. So with those thoughts in mind, it is paramount for medical professionals primarily doctors, mid-level practitioners, and nurses begin to emphasize primary prevention and treatment in an effort to preserve health status and disease prevention. It was through a research review of an article entitled Interpreting Cardiac Troponin Results from High-Sensitivity Assays in Chronic Kidney Disease without Acute Coronary Syndrome, (diFilippi et al 2012) that accurately states the clinical problem of high troponin levels in patients with chronic kidney disease and answers the clinical question of “ In patients diagnosed with chronic kidney disease not currently experiencing active acute coronary syndrome, which troponin marker (cTnT), or (cTnI) result in a high sensitivity assay in the stable outpatient arena.” The research review has been complied into a brochure intended to target outpatient healthcare professionals caring for stable chronic kidney disease …show more content…
The study and results were derived from outpatient neurology clinics from Massachusetts General Hospital, Boston; University of Maryland, Baltimore; and lastly the Baltimore Veteran’s Administration Medical center. The eligibility to be included in the study hinged on the several factors including age, and overall reduction in estimated glomerular filtration rate as well as numerous other factors. Participants were excluded if the patient was diagnosed with stage five kidney disease or had already received renal replacement therapy (dialysis or kidney transplant), or had previous history of cardiovascular conditions such as coronary artery bypass graft or myocardial infarction within the past ninety days of enrollment. The universal definition states that for myocardial infarction to be present, an increased troponin level must exceed the measurement of the ninety ninth percentile of a healthy reference population (deFilippi et al., 2012). The normal tropoinin level for troponin T should reflect < 0.01. The normal level for the troponin I should reflect < 0.04. Serial troponins concentrations rise can and fall between three and six hours after the initial event has occurred. The studies conducted measured (cTnT)
David J Sasso Jr, BSN, RN
Rhode Island College
Dr. Creamer
Professional Role Development
N 503
12 March 2015
Abstract
The clinical problem of chronic kidney disease is one that affects approximately twenty six million Americans annually. The signs and symptoms of this disease are common and most times nonspecific meaning they can be manifested by other diseases. The complications this disease causes are enormous and intimidating, so it is extremely imperative when we are assessing our patients for potential complications, we interpret the lab results accordingly. A review of research provides a different interpretation of two different types of troponin levels from patients …show more content…
As with any other medical condition, we know that early detection is key to prevent disease progression to kidney failure. So with those thoughts in mind, it is paramount for medical professionals primarily doctors, mid-level practitioners, and nurses begin to emphasize primary prevention and treatment in an effort to preserve health status and disease prevention. It was through a research review of an article entitled Interpreting Cardiac Troponin Results from High-Sensitivity Assays in Chronic Kidney Disease without Acute Coronary Syndrome, (diFilippi et al 2012) that accurately states the clinical problem of high troponin levels in patients with chronic kidney disease and answers the clinical question of “ In patients diagnosed with chronic kidney disease not currently experiencing active acute coronary syndrome, which troponin marker (cTnT), or (cTnI) result in a high sensitivity assay in the stable outpatient arena.” The research review has been complied into a brochure intended to target outpatient healthcare professionals caring for stable chronic kidney disease …show more content…
The study and results were derived from outpatient neurology clinics from Massachusetts General Hospital, Boston; University of Maryland, Baltimore; and lastly the Baltimore Veteran’s Administration Medical center. The eligibility to be included in the study hinged on the several factors including age, and overall reduction in estimated glomerular filtration rate as well as numerous other factors. Participants were excluded if the patient was diagnosed with stage five kidney disease or had already received renal replacement therapy (dialysis or kidney transplant), or had previous history of cardiovascular conditions such as coronary artery bypass graft or myocardial infarction within the past ninety days of enrollment. The universal definition states that for myocardial infarction to be present, an increased troponin level must exceed the measurement of the ninety ninth percentile of a healthy reference population (deFilippi et al., 2012). The normal tropoinin level for troponin T should reflect < 0.01. The normal level for the troponin I should reflect < 0.04. Serial troponins concentrations rise can and fall between three and six hours after the initial event has occurred. The studies conducted measured (cTnT)