Abstract: TH-PO0299
To Cath or Not to Cath: Ending the Feud Between Cardiologists and Nephrologists by Analyzing Angiographic Correlation of Troponin T in Patients with CKD
Session Information
- Hypertension and CVD: Clinical - 1
November 06, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Hypertension and CVD
- 1602 Hypertension and CVD: Clinical
Authors
- Hti Lar Seng, Nang San, Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States
- Varrias, Dimitrios, Yale New Haven Health, New Haven, Connecticut, United States
- Lee, Pei Lun, New York City Health and Hospitals Jacobi, New York, New York, United States
- Aung, Htun Min, New York City Health and Hospitals Jacobi, New York, New York, United States
- Chi, Kuan-Yu, New York City Health and Hospitals Jacobi, New York, New York, United States
- Sun, Guanqing Christian, New York City Health and Hospitals Jacobi, New York, New York, United States
- Umana, Chinweizu Deborah, New York City Health and Hospitals Jacobi, New York, New York, United States
- Tufail, Muhammad Umer, New York City Health and Hospitals Jacobi, New York, New York, United States
- Rodriguez Salazar, Juan Diego, New York City Health and Hospitals Jacobi, New York, New York, United States
- Jim, Belinda, New York City Health and Hospitals Jacobi, New York, New York, United States
Background
Diagnosing acute coronary syndrome (ACS) in chronic kidney disease (CKD) patients is challenging due to baseline elevation of troponin T from reduced clearance and underlying cardiovascular comorbidities. This study investigates the relationship between troponin T levels and angiographic coronary artery disease (CAD) in CKD patients.
Methods
We retrospectively analyzed patients who underwent coronary angiography or left heart catheterization for ACS at Jacobi Medical Center, Bronx, NY, from 2017–2024, during which Troponin T was the biomarker used. CAD severity was defined as mild (<50%), moderate (50–69%), or severe (>70% stenosis). Patients with prior CABG or chronic total occlusion were excluded. CKD stages were categorized per KDIGO guidelines. Statistical analysis was conducted using R (RStudio Ocean Storm 2023.12.1).
Results
Out of 1,286 patients (mean age 62±12 years; 63% male), CKD staging was: stage 1 (25%), stage 2 (42%), stage 3a (16%), stage 3b (7%), stage 4 (2%), and ESRD (7%). CAD severity showed 30% with no stenosis, 11% mild, 8% moderate, and 51% severe. Peak troponin T was approximately 10 times higher in CKD stages 3b, 4, and ESRD compared to stages 3a and below (p = 0.01). Severe stenosis was independently associated with elevated troponin T across all CKD stages. Using the Youden index, optimal peak troponin T cutoffs for predicting severe stenosis were: ESRD (0.59), CKD 4 (0.58), CKD 3b (0.68), CKD 3a (0.10), CKD 2 (0.03), and CKD 1 (0.01).
Conclusion
The threshold of troponin T for detecting severe CAD increases significantly in advanced CKD, with CKD 3b showing the highest optimal cutoff—likely due to troponin clearance by dialysis in ESRD patients. These findings underscore that troponin T levels are intrinsically higher in patients with GFR <60 and offer stage-specific thresholds to guide angiographic evaluation in CKD patients presenting with ACS.