Cardiac-specific troponin-l radioimmunoassay in the diagnosis of acute myocardial infarction

Cummins, Bernadette; Auckland, M.L.; Cummins, Peter L.

doi:10.1016/0002-8703(87)90645-4

Cited by 375 publications

(111 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…It has three tissue isoforms – fast troponin I and slow troponin I, expressed in fast-twitch and slow-twitch skeletal muscles, respectively, and cardiac troponin I, with an N-terminal site having an additional chain of 26-amino acid residues expressed in cardiac myocytes [25, 30, 31]. Serum cardiac troponin I levels above the normal value can be detected within 3–6 h after the myocardial injury, peaks at 12–24 h and may remain elevated for 4–9 days [5, 6].…”

Section: Discussionmentioning

confidence: 99%

“…Over the last few years, various studies have shown that cardiac troponin I measured by radioimmunoassay methods has sensitivity comparable to creatine kinase-MB isoenzyme and cardiac troponin T, especially with recently developed monoclonal antibodies to cardiac troponin I that have no cross-reactivity to skeletal muscle forms [5, 6, 25, 26, 27, 28, 29]. Since cardiac troponin I is exclusively of cardiac origin and, unlike creatine kinase-MB isoenzyme and cardiac troponin T, does not express in the skeletal muscle at any developmental stage [30, 31, 32, 33, 34], it has been shown to be more specific for the detection of myocardial injury in chronic renal failure patients [21, 22, 23, 29].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Specificity of Cardiac Troponin I and Creatine Kinase-MB Isoenzyme in Asymptomatic Long-Term Hemodialysis Patients and Effect of Hemodialysis on These Cardiac Markers

et al. 1998

View full text Add to dashboard Cite

Objectives: The objectives of this study were: (1) to evaluate the specificity of cardiac troponin I and creatine kinase-MB isoenzyme in ambulatory asymptomatic chronic renal failure patients on long-term hemodialysis, and (2) to evaluate the effect of hemodialysis on the serum levels of cardiac troponin I and creatine kinase-MB isoenzyme. Methods: One hundred and forty-four consecutive ambulatory asymptomatic chronic renal failure patients on hemodialysis for a minimum of 1 year were evaluated clinically. Serum cardiac troponin I and creatine kinase-MB isoenzyme levels were measured with specific monoclonal antibodies before and after dialysis using ACCESS Troponin I and ACCESS CK-MB assays. Results: The specificity of serum cardiac troponin I was 83% with a cutoff level of 0.03 ng/ml, which is an expected level for healthy population, but it rose to 100% with a cutoff level of 0.15 ng/ml, which is a reference level for patients with acute myocardial infarction. Twenty-four (17%) patients had borderline elevation in cardiac troponin I (>0.03 to <0.15 ng/ml). A history of angina pectoris was more common in the borderline-elevated cardiac troponin I subgroup. In 28% of the patients, serum creatine kinase-MB isoenzyme levels were increased with a specificity of 72% at a cutoff level of 4 ng/ml, which is the upper limit of normal, but the specificity rose to 98% by increasing the cutoff level value to 10 ng/ml. There were no statistically significant differences in serum levels of cardiac troponin I and creatine kinase-MB isoenzyme before and after dialysis. Conclusions: Cardiac troponin I is highly specific in ambulatory asymptomatic chronic renal failure patients on long-term hemodialysis; borderline elevations in cardiac troponin I may represent microinjury to the myocardium. A serum level of creatine kinase-MB isoenzyme >2.5 times of the normal upper limit may be highly specific in this patient population. Hemodialysis per se does not significantly change the serum levels of cardiac troponin I and creatine kinase-MB isoenzyme.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Specificity of Cardiac Troponin I and Creatine Kinase-MB Isoenzyme in Asymptomatic Long-Term Hemodialysis Patients and Effect of Hemodialysis on These Cardiac Markers

et al. 1998

View full text Add to dashboard Cite

show abstract

“…They are also too expensive for wide screening programs or routine measurements inside hos-pitals, mostly because they rely on natural antibodies. These include enzyme linked immunosorbent assay (ELISA) (Katus et al, 1989), radioimmunoassay (RIA) (Cummins et al, 1987), immunochromatographic (Penttil et al, 1999) tests, electrochemiluminescence immunoassay (Klein et al, 1998), and surface plasmon resonance (SPR) Dutra et al, 2007). Alterna-tive methods employ highly sophisticated separative procedures (Cavaliere et al, 2008;Labugger et al, 2003;Risnik et al, 1985) that are of high cost and unsuitable to carry out on-site analysis (at least outside central hospitals).…”

Section: Introductionmentioning

confidence: 99%

Artificial antibodies for troponin T by its imprinting on the surface of multiwalled carbon nanotubes: Its use as sensory surfaces

Moreira

Dutra

Noronha

et al. 2011

Biosensors and Bioelectronics

View full text Add to dashboard Cite

A novel artificial antibody for troponin T (TnT) was synthesized by molecular imprint (MI) on the surface of multiwalled carbon nanotubes (MWCNT). This was done by attaching TnT to the MWCNT surface, and filling the vacant spaces by polymerizing under mild conditions acrylamide (monomer) in N,N * -methylenebisacrylamide (cross-linker) and ammonium persulphate (initiator). After removing the template, the obtained biomaterial was able to rebind TnT and discriminate it among other interfering species. Stereochemical recognition of TnT was confirmed by the non-rebinding ability displayed by non-imprinted (NI) materials, obtained by imprinting without a template. SEM and FTIR analysis confirmed the surface modification of the MWCNT. The ability of this biomaterial to rebind TnT was confirmed by including it as electroactive compound in a PVC/plasticizer mixture coating a wire of silver, gold or titanium. Anionic slopes of 50 mV decade −1 were obtained for the gold wire coated with MI-based mem-branes dipped in HEPES buffer of pH 7. The limit of detection was 0.16 µg mL −1 . Neither the NI-MWCNT nor the MWCNT showed the ability to recognize the template. Good selectivity was observed against creatinine, sucrose, fructose, myoglobin, sodium glutamate, thiamine and urea. The sensor was tested successfully on serum samples. It is expected that this work opens new horizons on the design of new artificial antibodies for complex protein structures.

show abstract

“…For accurate therapeutic decisions, it is indispensable to estimate the individual risk profile for each patient. Measurements of the enzymes creatine kinase (CK) and its cardioselective isoform CK-MB as well as electrocardiographic results are routinely used as criteria to assess the individual risk for subsequent myocardial infarction [2, 3, 4, 5, 6, 7, 8]. However, objective evidence from the first electrocardiogram may be inadequate and levels for CK and CK-MB are often elevated for noncardiac reasons, since these enzymes are not exclusively expressed in heart tissue.…”

Section: Introductionmentioning

confidence: 99%

Superiority of Combined CK-MB and Troponin I Measurements for the Early Risk Stratification of Unselected Patients Presenting with Acute Chest Pain

Meyer

Binder²,

Graeber³

et al. 1998

Cardiology

View full text Add to dashboard Cite

Background: Recent studies have suggested that positive troponin I tests are associated with an increased risk of cardiac death during short-term follow-up. However, it is unknown if troponin I tests alone or in addition to CK-MB measurements are superior to predict unfavorable outcome during long-term follow-up. Patients and Methods: In a prospective, double-blind study we assessed the prevalence and prognostic value of combined troponin I and CK-MB tests in an unselected cohort of patients (n = 292) admitted to the emergency department for acute chest discomfort. Patients were grouped according to the diagnosis on discharge in those with acute myocardial infarction (1), unstable angina (2), and noncardiac chest pain (3). Six months after enrollment, death rates were obtained and follow-up interviews were performed with respect to survival, recurrence of chest pain, and myocardial infarction. Results: In patients with evidence of coronary heart disease, the mortality rate for abnormal troponin I and normal CK-MB levels was 5.0%. Baseline troponin I and elevated CK-MB levels were associated with a mortality rate of 4.0%. However, the mortality rate was significantly higher (11.1%) in patients presenting with elevated troponin I and CK-MB values. In patients without myocardial infarction on admission, 10.5% with positive troponin I tests died compared to 1.6% with negative tests. The mortality rate in patients without myocardial infarction was 2.7% for patients with elevated CK-MB but normal troponin I values. In patients with both markers elevated a significantly higher mortality rate (16.7%) was found, representing a 6-fold increase in the death event rate. With the additional knowledge of troponin I values, it could be demonstrated that certain cases were misclassified as having noncardiac chest pain. At least some of the latter patients with above-normal values of troponin I were retrospectively to be reclassified as unstable angina. Acute non-Q-wave myocardial infarctions were occasionally misdiagnosed as either angina pectoris or nonischemic chest pain. Conclusions: Our data suggest the superiority of combined CK-MB and troponin I measurements in clinical practice for the early risk stratification of patients presenting with acute chest pain. In nonmyocardial infarctions, both CK-MB and troponin I convey independent prognostic information with regard to fatal outcome. Troponin I tests in addition to CK-MB measurements contribute to a lower rate of misdiagnoses.

show abstract

Cardiac-specific troponin-l radioimmunoassay in the diagnosis of acute myocardial infarction

Cited by 375 publications

References 28 publications

Specificity of Cardiac Troponin I and Creatine Kinase-MB Isoenzyme in Asymptomatic Long-Term Hemodialysis Patients and Effect of Hemodialysis on These Cardiac Markers

Specificity of Cardiac Troponin I and Creatine Kinase-MB Isoenzyme in Asymptomatic Long-Term Hemodialysis Patients and Effect of Hemodialysis on These Cardiac Markers

Artificial antibodies for troponin T by its imprinting on the surface of multiwalled carbon nanotubes: Its use as sensory surfaces

Superiority of Combined CK-MB and Troponin I Measurements for the Early Risk Stratification of Unselected Patients Presenting with Acute Chest Pain

Contact Info

Product

Resources

About