Analytical Issues Surrounding Troponin Assays

Troponin Elevations are Greater and Persist Over Longer Time Periods

October 2010

Cardiac troponin is a structural biomarker of cardiac necrosis and is the best marker for definitive AMI diagnosis. Troponins appear in the serum relatively early after the onset of symptoms and remain abnormal for 4-10 days. Elevations of troponin T persist longer than troponin I because it is larger (at 37 kDa versus 24 kDa). Although worth noting is an increase in troponin after unstable angina or small myocardial infarction, although in both situations the troponin concentration would be above the 99th percentile.

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Troponin Elevations

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Jump to section:

• Introduction
• Challenges in Cardiovascular Medicine
• Shades of Gray
• Cardiac Markers
• Troponin Elevations are Greater and Persist Over Longer Time Periods
• 2007 Universal Definition of MI1
• Serial Sampling
• Elevation of cTn in Patients Without Overt Ischemic Heart Disease¹
• Analytic Confusion: Sensitivity and Imprecision of cTn Assays
• Analytical Definitions (Related to Troponin)
• Current Troponin Assays
• Defining the 99th Percentile (Normal Population)
• Troponin T or Troponin I: Does it Matter?
• Is CK-MB Needed Anymore?
• Recommendations for Point-of-Care Cardiac Marker Testing^2,3
• Does POCT Make Any Difference?
• What About the High-Sensitive Troponin Assays?
• Why All the Hype for High-Sensitivity Troponin?
• Troponin Concentrations and Diagnostic Accuracy⁴
• How Sensitive Does Troponin Testing Really Need to Be?
• Current Mayo Cardiac Biomarker Panel
• Current Mayo Cardiac Biomarker Panel
• Conclusions
• References
• Questions?
• Disclosure