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enseignants",{"title":54,"url":55},{"title":57,"url":58},{"title":186,"group":48,"menu":187},"Produit",[188,189,190,191,192,193,194],{"title":38,"url":7},{"title":65,"url":66},{"title":68,"url":69},{"title":71,"url":72},{"title":74,"url":75},{"title":15,"url":77},{"title":195,"url":10},"Tarification",{"title":197,"group":48,"menu":198},"Mentions légales",[199,200,201,202,203],{"title":197,"url":84},{"title":86,"url":87},{"title":89,"url":90},{"title":92,"url":93},{"title":95,"url":96},{"title":205,"group":48,"menu":206},"Service client",[207,208,209],{"title":101,"url":102},{"title":104,"url":105},{"title":107,"url":108},{"content":211,"related":284,"meta":357,"internal":367},{"title":212,"leadIn":213,"category":214,"elements":217,"becomeAnExpert":250,"author":272,"readDuration":282,"readDurationFormatted":283},"Interpreting troponin in chronic kidney disease","Learn about the influence of chronic kidney disease on troponin levels.",{"id":215,"name":216},1,"Course previews",[218,228,233,238,245],{"type":219,"data":220},"video",{"readDurationInSeconds":221,"video":222},194,{"platform":223,"name":212,"url":224,"size":225},"YouTube","https:\u002F\u002Fwww.youtube.com\u002Fwatch?v=4Q1s_Bl4hKw",{"width":226,"height":227},200,113,{"type":229,"data":230},"free_text",{"readDurationInSeconds":231,"text":232},10.666666666666666,"\u003Cp>Troponin is a useful biomarker to track in patients who've experienced acute coronary syndrome. In this video, from our Cardiology Lab Essentials course, you'll learn about the influence of chronic kidney disease on troponin levels and how to interpret these levels in order to support your overall patient management plan.\u003C\u002Fp>",{"type":229,"data":234},{"readDurationInSeconds":235,"title":236,"text":237},11.733333333333334,"Join our Cardiology Lab Essentials course today!","\u003Cp>Master the ins-and-outs of cardiology lab testing with our \u003Cstrong>\u003Ca href=\"https:\u002F\u002Fwww.medmastery.com\u002Fcourse\u002Fcardiology-lab-essentials\">Cardiology Lab Essentials\u003C\u002Fa>\u003C\u002Fstrong> course. You'll take a deep dive into the lab tests requested for common cardiology conditions, when to request them, how to interpret the results, and much more!\u003C\u002Fp>",{"type":239,"data":240},"cta",{"readDurationInSeconds":241,"text":242,"buttonText":243,"buttonUrl":244},3.466666666666667,"Become a great clinician with our video courses and workshops","Start learning for free","https:\u002F\u002Fwww.medmastery.com\u002Fuser\u002Fregister",{"type":229,"data":246},{"readDurationInSeconds":247,"title":248,"text":249},89.06666666666666,"Video Transcript","\u003Cp dir=\"ltr\">\u003Cstrong>[00:00:00]\u003C\u002Fstrong> In patients with chronic kidney disease, diagnosing acute myocardial infarction is much more challenging than in a general population. This is because some cardiac biomarkers act differently when renal function is impaired. So, how can we use cardiac lab markers in chronic kidney disease or CKD for short? Even in the absence of any clinical evidence of myocardial damage, troponin elevations are pretty common in patients with CKD, especially \u003C\u002Fp>\u003Cp dir=\"ltr\">\u003Cstrong>[00:00:30]\u003C\u002Fstrong> as renal impairment progresses. Today, it is clear that these elevations are not caused solely by the impaired renal function and decreased renal clearance but that chronic myocardial injury or structural heart disease also contribute to troponin elevation in these patients. Furthermore, we know that stably elevated cardiac troponin concentrations in CKD patients are associated with a poor long-term survival. Interestingly, it was observed that cardiac troponin I \u003C\u002Fp>\u003Cp dir=\"ltr\">\u003Cstrong>[00:01:00]\u003C\u002Fstrong> is less often elevated than comparison to troponin T, so some advocate the use of troponin I testing in CKD patients. However, with increasing sensitivity of tests, these differences diminish. So, what should you do if you suspect your CKD patient, with chronic troponin elevations, of having an acute myocardial infarction? Can you still use cardiac biomarkers to diagnose an acute myocardial infarction? The good news is, yes, you can. As with diagnostic criteria for individuals \u003C\u002Fp>\u003Cp dir=\"ltr\">\u003Cstrong>[00:01:30]\u003C\u002Fstrong> with no renal impairment, troponin is the preferred marker for diagnosing myocardial infarction and it is crucial to not rely on one single measurement but instead to use serial measurements and to interpret the changes in troponin levels. This will improve the specificity of your results. In patients with chronically elevated troponin levels, at or above the upper reference limit, a greater than 20% increase in serially measured troponin is generally recommended \u003C\u002Fp>\u003Cp dir=\"ltr\">\u003Cstrong>[00:02:00] \u003C\u002Fstrong>as an acceptable threshold for an acute MI, of course, along with appropriate clinical presentation. What about dialysis? Does dialysis have an impact on troponin levels? There are controversial results from studies addressing this question. Although it is best to consider the timing of dialysis when interpreting your lab results, dialysis does not alter diagnostic criteria. So, what are the take-home messages? First, don't ignore changes in troponin in patients with chronic kidney disease.\u003C\u002Fp>\u003Cp dir=\"ltr\">\u003Cstrong>[00:02:30] \u003C\u002Fstrong>These increase troponin levels may represent myocardial damage. You should definitely check for coronary heart disease. And second, large changes require fast action. If you suspect myocardial infarction and your patient already had increased troponin levels before, check for change of more than 20% in troponin levels, in serial measurements.\u003C\u002Fp>",{"courses":251,"showAwardsBelow":48},[252],{"id":253,"isFreeCmeCourse":254,"title":255,"type":256,"specialization":257,"teachers":259,"cmeCredits":261,"teacherIllustration":262,"backgroundImage":263,"relativeUrl":264,"lastChanged":265,"created":266,"description":267,"relativeURL":264,"meta":268},5510,false,"Cardiology Lab Essentials","course",[258],"Cardiology",[260],"Anna Wonnerth, MD",3,"https:\u002F\u002Fmedmastery-backend-prod-kjbeds.s3.eu-west-1.amazonaws.com\u002Fmedia\u002Fimages\u002F99f55e87-d664-44f3-8684-6cf291cb0863","https:\u002F\u002Fmedmastery-backend-prod-kjbeds.s3.eu-west-1.amazonaws.com\u002Fmedia\u002Fimages\u002F99f55e88-ae2c-4828-816c-1e49f773c3c4","\u002Fcourses\u002Fcardiology-lab-essentials","1763556344","1539019847","The modern cardiology labs landscape can be very confusing. 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Learn to recognize and report it with exercise stress ECG.",{"alt":290,"title":291,"size":292,"location":294},"Illustration of the heart's coronary vasculature showing large coronary arteries and the extensive network of smaller vessels affected in INOCA (ischemia with nonobstructive coronary arteries).","",{"width":293,"height":293},1200,{"bucket":295,"key":296},"public-drupal-medmastery-assets-production","\u002F2026-05\u002FC17(1)_magazine image_0.png",{"id":298,"title":299,"relativeURL":300,"image":301,"professionLong":302,"profession":303,"weight":305},1563,"Franz Wiesbauer, MD MPH","\u002Fteachers\u002Ffranz-wiesbauer-md-mph","https:\u002F\u002Fmedmastery-backend-prod-kjbeds.s3.eu-west-1.amazonaws.com\u002Fmedia\u002Fimages\u002F9c43cef0-41ee-4005-9e4a-d8711c816401","Franz is the founder and CEO of Medmastery. He is an internist with a specialization in cardiology and a master’s in public health from Johns Hopkins University.",{"name":304},"Internist",4,"\u002Fmagazine\u002Fexercise-stress-ecg-inoca",141,"3m",{"created":310,"updated":311,"published":312},1778115738,1778118425,1778118255,{"id":314,"title":315,"text":316,"image":317,"author":323,"path":325,"readDuration":326,"readDurationFormatted":327,"internal":328},1348,"Hyperlipidemia screening: who, when, & what to measure","Testing for hyperlipidemia can help you mitigate your patients' cardiovascular risk. Learn who to screen and when, which measures to request, and how to stratify risk.",{"alt":318,"title":291,"size":319,"location":321},"Lipid panel blood sample tubes used to test for hyperlipidemia in a laboratory setting",{"width":320,"height":320},600,{"bucket":295,"key":322},"\u002F2026-04\u002FC121_magazine image.png",{"id":298,"title":299,"relativeURL":300,"image":301,"professionLong":302,"profession":324,"weight":305},{"name":304},"\u002Fmagazine\u002Ftest-for-hyperlipidemia",246,"5m",{"created":329,"updated":330,"published":331},1777403036,1777572381,1777412421,{"id":333,"title":334,"text":335,"image":336,"author":341,"path":350,"readDuration":351,"readDurationFormatted":352,"internal":353},1347,"Outpatient care for COPD exacerbations","Most acute COPD exacerbations can be managed with outpatient treatment. Learn how to treat mild and moderate COPD exacerbations—and when to escalate care.",{"alt":337,"title":291,"size":338,"location":339},"Older patient using a handheld nebulizer to inhale bronchodilator medication during an acute COPD exacerbation",{"width":320,"height":320},{"bucket":295,"key":340},"\u002F2026-04\u002FC133(4)_ exacerbations_magazine image.png",{"id":342,"title":343,"relativeURL":344,"image":345,"professionLong":346,"profession":347,"weight":349},5365,"Siamak Moayedi, MD","\u002Fteachers\u002Fsiamak-moayedi-md","https:\u002F\u002Fmedmastery-backend-prod-kjbeds.s3.eu-west-1.amazonaws.com\u002Fmedia\u002Fimages\u002F9c43cf02-1064-4074-817b-0eb5de6ded74","Professor and Director of Medical Student Education, University of Maryland and Course Director, Essential and Critical Procedures, Emergency Medicine.",{"name":348},"Emergency medicine physician",1533,"\u002Fmagazine\u002Facute-copd-exacerbation-treatment",191,"4m",{"created":354,"updated":355,"published":356},1776705362,1776710540,1776710541,{"seo":358,"og":360},{"title":359,"description":213},"Interpreting troponin in chronic kidney disease | Medmastery",{"title":359,"description":213,"image":361},{"alt":291,"title":291,"size":362,"location":365},{"width":363,"height":364},640,327,{"bucket":295,"key":366},"\u002Fmigrated-images\u002FScreen Shot 2018-10-23 at 9.20.49 am.png",{"id":368,"created":369,"updated":370,"published":369},267,1539786060,1655189586]