Abstract: Objectives  To investigate the variation of serum cardiac troponin T (cTnT) and its clinical value in hemodialysis patients with acute myocardial infarction (AMI).  Methods  We retrospectively studied the cTnT level and its variation trend in hemodialysis patients and normal renal function patients with AMI, to determine the relationship between cTnT level and the degree of AMI, and to predict the rate of recurrent AMI and mortality.  Results   During non-AMI stage, the baseline cTnT level was 147.25 (92.85, 236.65) ng/L in hemodialysis patients, significantly higher than that of 25.0 (15.0, 52.3) ng/L in normal renal function patients (Z=-11.595, P<0.001), and the cut-off value of cTnT  for the diagnosis of AMI was 396.45ng/L. During AMI stage, the peak level of cTnT was 1938.0 ng/L in hemodialysis patients, higher than that of 1036.5ng/L in normal renal function patients (Z=-6.041, P＜0.001); cTnT reached a peak after 4.0 days, with an overall duration of 23.0 days in hemodialysis patients, longer than the values in normal renal function patients (Z=-6.771 and -9.592; P<0.001). Peak cTnT level was positively correlated with ECG ischemia grade in hemodialysis patients (r=0.620, P<0.001). Peak cTnT was positively correlated with AMI recurrence (r=0.907, P<0.001) and all-cause death (r=0.938, P<0.001).  Conclusions   Higher cTnT cutoff value is required for the diagnosis of AMI in hemodialysis patients. Compared with AMI in normal renal function patients, the peak level of cTnT is higher and lasts longer in AMI of hemodialysis patients, but the values can still be useful to reflect the degree of AMI and to predict AMI recurrence and mortality.

Key words: Hemodialysis, Acute myocardial infarction, Variation, Clinical value, Assess