How does a high sensitivity cardiac troponin I assay help us when patients with chronic renal failure present to the emergency department?

The frequency of chronic kidney disease (CKD) increases with age and CKD is present in 45% of the USA population at the age of seventy (1). Cardiovascular disease is more common in those with CKD and death from cardiovascular disease as well as events and hospitalisation are increased in this population (2,3). Therefore, there is a significant interest in patients who present with acute myocardial infarction (AMI) in the setting of CKD. Previous data have shown worse outcomes in patients with AMI who have coexistent renal dysfunction (4).