Kidney Function-Specific Performance of High-Sensitivity Troponin T and I Using 0/1 h and 0/3 h Protocols in…

Cohort studyBiomedicines· Jun 2026

Kidney Function-Specific Performance of High-Sensitivity Troponin T and I Using 0/1 h and 0/3 h Protocols in Suspected Non-ST-Segment Elevation Acute Coronary Syndrome.

Krongkarn Sutham, Boriboon Chenthanakij, Aumarin Kumpool … Wachira Wongtanasarasin

Acute Chest Pain & TroponinCohort studyDiagnosisQ1IF 4.7

3-hour troponin I was most sensitive for acute coronary syndrome in impaired kidney function

Kidney Function-Specific Performance of High-Sensitivity Troponin T and I Using 0/1 h and 0/3 h Protocols in Suspected Non-ST-Segment Elevation Acute Coronary Syndrome.

Krongkarn Sutham … Wachira Wongtanasarasin

Biomedicines · Jun 2026 · Q1 in General Medicine

Background

Impaired kidney function is associated with persistently elevated cardiac troponin levels, complicating evaluation of suspected non-ST-segment elevation acute coronary syndrome (NSTE-ACS).

Purpose

We aimed to identify a kidney function-adapted assay-sampling protocol combination for suspected NSTE-ACS that may support collaborative pathways between nephrologists and acute care clinicians.

Methods

Were stratified according to kidney function at presentation using estimated glomerular filtration rate (eGFR).

n = 140 patients

Results

3-hour troponin I caught most ACS cases in impaired kidney function

hs-cTnI Sensitivity

88.6%

hs-cTnT NPV

92.2%

More results

Among 140 patients, 58 (41%) had impaired kidney function.

In this group, the 0/3 h protocol demonstrated superior diagnostic performance compared with the 0/1 h protocol for both assays.

In patients with preserved kidney function, both assays demonstrated high specificity and positive predictive value with the 0/3 h protocol.

More results

Prognostic discrimination for 30-day major adverse cardiovascular events also improved with a 0/3 h strategy, particularly in patients with impaired kidney function.

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Conclusion

In patients with impaired kidney function and suspected NSTE-ACS, extending troponin testing to 3 h improves diagnostic accuracy and short-term prognostic performance, supporting kidney function-adapted troponin strategies in emergency and nephrology care.

Kidney Function-Specific Performance of High-Sensitivity Troponin T and I Using 0/1 h and 0/3 h Protocols in Suspected Non-ST-Segment Elevation Acute Coronary Syndrome.

Kidney Function-Specific Performance of High-Sensitivity Troponin T and I Using 0/1 h and 0/3 h Protocols in Suspected Non-ST-Segment Elevation Acute Coronary Syndrome.

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