The Comparison of Cardiac Biomarkers Positivities in Hemodialysis Patients without Acute Coronary Syndrome

Abstract

Aim: We aimed to compare heart-type fatty acid-binding proteins (H-FAB) and other cardiac biomarkers to determine the most reliable cardiac marker in hemodialysis (HD) patients without acute coronary syndrome (ACS). Materials and methods: Sixty HD patients without ACS were included the study. Blood samples were taken before HD session for measurement of H-FAB, troponin I, troponin T, creatine kinase-MB (CK-MB) isoforms. Results: Mean age of patients was 55 ± 15 years. Males were 55%. Mean serum level of blood urea nitrogen was 75 ± 15 mg/dL, mean serum level of creatinine was 8.3 ± 2.5 mg/dL, mean serum level of hematocrit was 33 ± 5%, mean ejection fraction was 54 ± 9%, and mean left ventricular mass index (LVMI) was 136 ± 54 g/m2. H-FAB was positive in 32%, troponin T in 20%, troponin I in 12%, and CK-MB in 5% of all patients. Three or four of all parameters were not positive together in any patient. While 5% of patients had positive troponin T with H-FAB, 3% of patients had positive troponin T with troponin I and 2% of patients had positive troponin I with H-FAB. Conclusion: Our study found that CK-MB had the lowest positivity in the HD patients without ACS. H-FAB had the highest rate of positivity in all markers. If only one marker is assessed it should be CK-MB. But using two parameters in HD patients in ACS diagnosis increases the reliability of diagnosis. If we use two biomarkers it should be CK-MB and troponin I.