Diagnostic accuracy of cardiac biomarkers in chronic kidney disease patients for detecting occurrence of acute coronary syndrome: A comparative study

Introduction: The diagnosis of coronary artery disease or acute coronary syndrome (ACS) is difficult in patients of chronic kidney disease (CKD). This study was planned to evaluate the role of cardiac biomarkers in diagnosis of ACS in such patients. To evaluate the role of biochemical cardiac markers in the diagnosis of ACS in patients with CKD and to study the relation of stage of kidney disease and biochemical cardiac biomarkers. Materials and Methods: Atotal of 350 patients in different stages of CKD were enrolled and subjected to measurement of blood levels of creatine kinase (CK) MB and Troponin I (Trop I). The data were analyzed by dividing subjects into groups based on positivity of biomarkers, presence of electrocardiogram (ECG) changes, and stage of CKD. Results: Sensitivity of CK MB and Trop I was 60.81% and 56.76% and specificity was 72.1% and 83.33%, respectively. Although both showed low positive predictive values, the negative predictive value of both CK MB and Trop I was good. Stage of CKD did not significantly affect the level or positivity of the biomarker in patients with ECG changes. Conclusions: CK MB and Trop I potentially rule out the probability of ACS in patients showing negative test results, which should always be interpreted in light of ECG changes in CKD patients.