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How Does Creatine Affect Troponin?

Nov 7, 2011 | By Beth Greenwood
How Does Creatine Affect Troponin?
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Troponin is the collective term used to describe three proteins in the cardiac muscle: troponins I, T and C. Troponin levels in a healthy person are too low to measure, so an elevated troponin is a sign of a heart attack or other heart muscle damage. Creatine breaks down to creatinine in the human body. Neither creatine nor creatinine affect troponin directly, but people who have renal failure have elevated creatinine levels. The combination of elevated creatinine levels and elevated troponin levels indicates an increased risk of early death.

Creatinine

Creatinine is a metabolic byproduct of creatine, a chemical that the human body synthesizes naturally; you can also obtain it from certain foods including fish and meat. Creatine is found in skeletal muscle, where it is gradually metabolized into creatinine and then excreted by the kidneys. If your kidneys are not functioning properly, creatinine builds up in the bloodstream. The serum creatinine test measures creatinine in the bloodstream and provides an indication of the kidney function; a high serum creatinine is a sign of kidney disease or failure.

Troponins and Creatinine

Cardiac complications are common in renal failure. Heart failure is the most likely cause of death in patients who have renal disease, according to an article in the May 2011 issue of “American Journal of Kidney Diseases.” A 2009 article in "Circulation," discusses the connection between an elevated troponin level and elevated serum creatinine. According to the article, trials indicate that patients in renal failure have elevated troponin levels and as such, the troponin test could indicate patients who would benefit from an intervention such as open heart surgery.

Troponin Tests in Renal Failure

A study in the July 2006 issue of “Heart” discusses the need to develop protocols for testing troponin levels in patients with advanced renal failure to determine when cardiac intervention is necessary. Part of the difficulty in deciding when to measure troponin is that troponin is excreted by the kidneys. In renal failure, kidney function is already compromised, making it difficult to determine if elevated troponins are due to an impending cardiac event or decreased troponin excretion.

Dialysis Patients and Troponin

Since renal failure patients have elevated troponin levels as part of the disease process, repeated testing is necessary to indicate if the heart problem is getting worse. As troponin levels rise, so does mortality. For dialysis patients, an article in the March 2009 issue of “F1000 Medicine Reports” recommends obtaining a troponin level prior to beginning dialysis. The author notes that an elevation of 20 percent or more in subsequent troponin levels should be considered diagnostic of an acute cardiac event such as a heart attack.

References

Article reviewed by Mia Paul Last updated on: Nov 7, 2011

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