Troponin: Difference between revisions

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imported>Howard C. Berkowitz
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imported>Robert Badgett
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  | volume = 328 | issue = 7447 | pages = 1028–1029.
  | volume = 328 | issue = 7447 | pages = 1028–1029.
  | doi = 10.1136/bmj.328.7447.1028
  | doi = 10.1136/bmj.328.7447.1028
  | author = Ammann P ''et al.'}}</ref> Troponin levels have become an important diagnostic tool in assessing [[acute coronary syndrome]], but it is dangerous to assume that ACS is the only reason they may be elevated. They supplement, but do not replace, the [[electrocardiogram]], history, and [[physical examination]].
  | author = Ammann P ''et al.'}}</ref> The level of troponin in the blood of normal individuals may be less than 0.0064 microg/l according to a study of a highly sensitive assay.<ref name="pmid19761938">{{cite journal| author=Venge P, Johnston N, Lindahl B, James S| title=Normal plasma levels of cardiac troponin I measured by the high-sensitivity cardiac troponin I access prototype assay and the impact on the diagnosis of myocardial ischemia. | journal=J Am Coll Cardiol | year= 2009 | volume= 54 | issue= 13 | pages= 1165-72 | pmid=19761938
| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=19761938 | doi=10.1016/j.jacc.2009.05.051 }} <!--Formatted by http://sumsearch.uthscsa.edu/cite/--></ref> However, even this cutoff level does not perfectly discriminate normal individuals from patients having [[acute coronary syndrome]].
 
Troponin levels have become an important diagnostic tool in assessing [[acute coronary syndrome]], but it is dangerous to assume that ACS is the only reason they may be elevated. They supplement, but do not replace, the [[electrocardiogram]], history, and [[physical examination]].


<center>'''Conditions associated with raised cardiac troponins (analytical causes excluded)'''</center>
<center>'''Conditions associated with raised cardiac troponins (analytical causes excluded)'''</center>

Revision as of 08:25, 23 September 2009

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Troponin is a protein of muscle, blood levels of which have become important in diagnosis. "Its function is to serve as the calcium-binding component in the troponin-tropomyosin B-actin-myosin complex by conferring calcium sensitivity to the cross-linked actin and myosin filaments.[1]

"Cardiac troponins are regulatory proteins of the thin actin filaments of the cardiac muscle. Troponin T and troponin I are highly sensitive and specific markers of myocardial injury."[2] The level of troponin in the blood of normal individuals may be less than 0.0064 microg/l according to a study of a highly sensitive assay.[3] However, even this cutoff level does not perfectly discriminate normal individuals from patients having acute coronary syndrome.

Troponin levels have become an important diagnostic tool in assessing acute coronary syndrome, but it is dangerous to assume that ACS is the only reason they may be elevated. They supplement, but do not replace, the electrocardiogram, history, and physical examination.

Conditions associated with raised cardiac troponins (analytical causes excluded)

Cardiac diseases and interventions

Cardiac amyloidosis

Cardiac contusion

Cardiac surgery

Cardioversion and implantable cardioverter defibrillator shocks

Closure of atrial septal defects

Coronary vasospasm

Dilated cardiomyopathy

Heart failure

Hypertrophic cardiomyopathy

Myocarditis

Percutaneous coronary intervention

Post cardiac transplantation

Radiofrequency ablation

Supraventricular tachycardia

Non-cardiac diseases

Critically ill patients

High dose chemotherapy

Primary pulmonary hypertension

Pulmonary embolism

Renal failure

Subarachnoid hemorrhage

Scorpion envenoming

Sepsis and septic shock

Stroke

Ultra-endurance exercise (marathon)


References

  1. Anonymous (2024), Troponin (English). Medical Subject Headings. U.S. National Library of Medicine.
  2. Ammann P et al.' (2004 May 1), "Raised cardiac troponins: Causes extend beyond acute coronary syndromes", BMJ 328 (7447): 1028–1029., DOI:10.1136/bmj.328.7447.1028
  3. Venge P, Johnston N, Lindahl B, James S (2009). "Normal plasma levels of cardiac troponin I measured by the high-sensitivity cardiac troponin I access prototype assay and the impact on the diagnosis of myocardial ischemia.". J Am Coll Cardiol 54 (13): 1165-72. DOI:10.1016/j.jacc.2009.05.051. PMID 19761938. Research Blogging.