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Review
. 2005 Nov 8;173(10):1191-202.
doi: 10.1503/cmaj/051291.

Troponin: the biomarker of choice for the detection of cardiac injury

Luciano Babuin  1 , Allan S Jaffe
Affiliations
Review

Troponin: the biomarker of choice for the detection of cardiac injury

Luciano Babuin et al. CMAJ. .

Erratum in

  • CMAJ. 2005 Dec 6;173(12):1490
  • CMAJ. 2006 Jan 31;174(3):353

Abstract

It has been known for 50 years that transaminase activity increases in patients with acute myocardial infarction. With the development of creatine kinase (CK), biomarkers of cardiac injury began to take a major role in the diagnosis and management of patients with acute cardiovascular disease. In 2000 the European Society of Cardiology and the American College of Cardiology recognized the pivotal role of biomarkers and made elevations in their levels the "cornerstone" of diagnosis of acute myocardial infarction. At that time, they also acknowledged that cardiac troponin I and T had supplanted CK-MB as the analytes of choice for diagnosis. In this review, we discuss the science underlying the use of troponin biomarkers, how to interpret troponin values properly and how to apply these measurements to patients who present with possible cardiovascular disease.

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Figures

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Fig. 1: Sensitivity of different cut-off values of cardiac troponin I (cTnI) over time; 0.07 mg/L = 99th percentile, 0.1 mg/L = 10% coefficient of variation, 0.4 mg/L = receiver operating characteristic (ROC) curve. Reprinted, with permission, from Eggers KM, Oldgren J, Nordenskjold A, et al. Diagnostic value of serial measurement of cardiac markers in patients with chest pain: limited value of adding myoglobin to troponin I for exclusion of myocardial infarction. Am Heart J 2004;148:574-81.
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Fig. 2: Morality rates according to level of cardiac troponin I at baseline. Reprinted, with permission, from Antman EM, Tanasijevic MJ, Thompson B, et al. Cardiac-specific troponin I levels to predict the risk of mortality in patients with acute coronary syndromes. N Engl J Med 1996;335:1342-9. Copyright © 1996 Massachusetts Medical Society. All rights reserved.
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Fig. 3: Cardiac troponin I and CK-MB levels in patients with acute myocardial infarction who experienced a reinfarction in hospital. Reprinted, with permission, from Apple FS, Murakami MM. Cardiac troponin and creatine kinase MB monitoring during in-hospital myocardial reinfarction. Clin Chem 2005;51(2): 460-3.
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See this image and copyright information in PMC

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