Evaluation of Troponin I Values in Acute Coronary Syndrome Patients with and without Impaired Renal Function

Background & Objective: Elevated cardiac troponin levels are common in chronic kidney disease (CKD) which make itchallenging to diagnose acute coronary syndrome in these patients. It is difficult to interpret the cardiac troponinlevels in CKD patients due to persistent increase of troponin levels in these patients which limit their diagnostic value.Our study aims to evaluate troponin-I levels in patients with acute coronary syndrome with and without impaired renalfunctionMethodology: Retrospective Cross-sectional study conducted in Pathology department, Shalamar Hospital Laboratory,Lahore from February 2025 to August 2025. A total of 202 Patients aged between 25 to 65 years both genders diagnosedas acute coronary syndrome with evaluated renal function were included. Data was divided in two groups i.e., Group A(Preserved renalfunction, eGFR≥60ml/min/1.73m2) Group B (Impaired renalfunction, eGFR<60ml/min/1.73m2). Troponin Ilevels were compared between patients with and without impaired renal function and p value <0.05 taken asstatistically significant.Results: Median age was 42 years in patients with preserved renal function and 53 years in patients with impaired renalfunction. Troponin I levels were significantly higher in patients with impaired renal function (6.80ng/ml) than in patientswith preserved renal function (3.80ng/ml). Weak negative, statistically insignificant correlation found between eGFRand troponin I (r, p value: -0.18, 0.09) in patients with preserved renal function (Group A). Moderate to strong,significant negative correlation between eGFR and troponin I (r, p value: -0.56, <0.001) in patients with impaired renalfunction (Group B). Statistically significant difference in troponin I levels between patients with preserved andimpaired renal function with higher levels in impaired group with P value 0.012.Conclusion: It has been concluded that serum troponin I levels are significantly higher in patients with acute coronarysyndrome with impaired renal function. These findings highlight the importance of interpreting troponin I values withcaution in acute coronary syndrome patients with renal impairment to avoid overdiagnosis of myocardial infarction.Further studies are recommended to establish adjusted diagnostic cutoff for troponin I in patients with impaired renalfunction to improve the clinical decision making.