NGHIÊN CỨU VỀ ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG VÀ NGƯỠNG TROPONIN T SIÊU NHẠY TRONG CHẨN ĐOÁN NHỒI MÁU CƠ TIM Ở BỆNH NHÂN BỆNH THẬN MẠN

Abstract

Background: Chronic kidney disease is independent factor relating to increase in prevalence- mortality because of acute coronary syndrome. A determination of acute myocardial infarction in patients with chronic kidney disease is a challenge when a marker as Hs-TnT is interfered if kidney function decreases, as false positive rate increases. Objectives: To discribe clinical and para-clinical characteristics of acute myocardial infarction in patients with chronic kidney disease; to determine the cut point of Hs-TnT in diagnostic of acute myocardial infarction in patients with chronic kidney disease. Materials and methods: Cross sectional study on 60 patients with chronic kidney disease with reduced glomerular filtration rate, divided into 2 groups including acute myocardial infarction and non-acute myocardial infarction, at Can Tho Central General hospital and Can Tho University of Medicine and Pharmacy Hospital in 2022-2024. Results: NonST elevation myocardial infarction rate was higher, the chest pain symptom proportion was 66.7%, the mean Hs-TnT was 0.763 ng/ml, the mean eGFR was 35.249 ml/min/1.73m², it had 22/30 patients supplied with coronary angiogram, in there, both 2-branch and 3-branch injuries were 26.7%. A new cut point of Hs-TnT for diagnosis of acute myocardial infarction in patients with chronic kidney disease was 0.162 ng/ml in general chronic kidney disease stage 3-5. Conclusions: Most acute myocardial infarction in chronic kidney disease occur in older adults and in patients with LDL-c wasn’t controlled well before the events happened, chest pain is the most complaint, the majority of these patients have diffuse coronary artery disease. A new cut point of Hs-TnT in diagnostic of acute myocardial infarction in patients with chronic kidney disease is different from and higher than it in the 99^th percentile of general population.