Clinical cardiology
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Clinical cardiology · Mar 2008
Prognostic value of troponins in patients with non-ST-segment elevation acute coronary syndromes and chronic kidney disease.
The prognostic value of cardiac troponins (cTn) in patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS) and chronic kidney disease (CKD) is debated. ⋯ In patients with CKD, cTnI and cTnT perform equally in differentiating short-term prognosis following NSTE ACS; however, the prognostic impact of cTn is dependent upon the degree of CKD severity.
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This report describes an example of a patient with chest pain and classic electrocardiographic changes consistent with ischemia in the proximal left anterior descending coronary artery (LAD) territory. This electrocardiogram (ECG) abnormality is known as Wellens' syndrome. However, the same abnormality is also described as inverted U-waves. The significance of this abnormality and the controversy of describing this syndrome is reviewed and discussed.