Correlation of Serum Creatine Kinase, Creatine Kinase-MB, and Troponin I with Cardiac Pathology in End-Stage Renal Disease Patients

Background: The increase of serum troponins, especially troponin 1, have been reported in patients with and without coronary artery diseases. Methods: We studied 51 end stage renal disease (ESRD) patients with or without clinical myocardial infarction (MI) and correlated cardiac findings with serum creatine kinase (CK), its MB isoenzyme (CK-MB), and cardiac troponin I (cTnI). Results: There was no myocardial pathology in 11 patients. Cardiac pathologies were in five groups: scarring from previous MI or patchy ventricular fibrosis (n = 5), recent MI (n = 8), recent microinfarct (n = 8), healing MI (n = 5), degenerative myocyte changes consistent with congestive heart failure CHF; (n = 8), and other cardiac pathologies (n = 6). The median concentrations in the five groups were not significantly different for either CK or CK-MB. Compared with the no-pathology group, only the MI group was significantly different for cTnI. For patients with recent MI, 37.5%, 25% and 75%, had increased CK, CK-MB and cTnI, respectively; for CHF the percentages were 62.5%,25% and 25% respectively. Only one patient without myocardial pathology had an increase of CK-MB, cTnI. Conclusions: All patients with increased serum CK-MB, and cTnI, had significant cardiac changes. cTnI assay appears to be a more sensitive indicator of MI and other myocardial pathologies than the CK-MB assay used in this study.