Lack of Association Between Cardiac Troponin T and D-Dimer in the Evaluation of Myocardial Damage

Abstract

Acute myocardial infarction (AMI) disrupts cardiac cell membranes, releasing intracellular cardiac proteins into the vascular system. Some of these proteins, including the cardiac troponin subunits T and I, have proven useful for diagnosing myocardial damage. Intracoronary thrombosis plays a key role in the pathogenesis of AMI, and the formation of an occlusive thrombus usually precedes the development of myocardial damage. To evaluate whether there is an association between the size of intracoronary thrombosis and myocardial damage, we analyzed D-dimer and cTnT levels in blood samples from patients suspected to have myocardial damage. We investigated 102 patients who were admitted to emergency service for suspected myocardial damage. D-dimer was assessed with the use of the immunoassay Liatest D-dimer, and cTnT levels were measured with an electrochemiluminescence immunoassay (Troponin T STAT). D-dimer levels were lower in patients with cTnT < 0.01 than in patients presenting cTnT > 0.01 ng/mL. We investigated the relationship between D-dimer and cTnT levels in the patients with cTnT > 0.01 ng/mL (0.40 +/- 0.10 ng/mL), and no significant agreement (r = 0.20, P > 0.05) was observed. The levels of D-dimer were not associated with the levels of cTnT in patients with cTnT > 0.01 ng/mL.

The implications of serum enzymes and coagulation activities in postinfarction myocardial

“…D-dimer was lower in patients with cardiac troponin T < 0.01 ng/ml than those with cardiac troponin T > 0.01 ng/ml. No correlation was found between D-dimer and cardiac troponin T levels in patients with cardiac troponin T > 0.01 ng/ml [1].…”

“…In the event of myocardial damage secondary to acute myocardial ischemia, intracellular cardiac proteins and enzymes are released into the circulation via cardiac cell membranes [1,2]. Patients with postinfarction myocardial rupture, a severe complication of acute myocardial infarction, often develop rapid hemodynamic deterioration [3], and are usually associated with more extensive myocardial damage [4], the assessment of which has not been fully conducted in a way similar to that of the myocardial infarction.…”

The Triple Work-Up for Emergency Department Patients with Acute Chest Pain: How Often does It Occur?

“…The serum D-dimer has also been found to be increased in patients with ACS, although sensitivity has been found to be poor when specificity is reasonable. Derhaschnig found a sensitivity of only 18% when the specificity was 92% (27)(28)(29).…”

Diagnostic value of D-dimer measurement in patients referred to the emergency department with suspected myocardial ischemia

“…Although increases in crosslinked fibrin degradation products were not sensitive enough for the diagnosis, they appear to predict those patients who are at higher risk for AMI-related complications [12]. Moresco et al observed that D-dimer levels are lower in patients with cTnT < 0.01 lg/l than in patients presenting cTnT > 0.01 lg/l, though D-dimer results are not associated with the levels of cTnT in patients with cTnT > 0.01 lg/l [13]. In a study on consecutive patients admitted to the coronary unit for evolving ACS within 6 h from the onset of infarct-related symptoms, D-dimer had a poor early sensitivity [14].…”