Measurement of cardiac troponins

The last 10 years have witnessed radical changes in the de nition and diagnosis of the acute coronary syndrome (ACS), including myocardial infarction, as a result of the introduction of sensitive and speci c markers of myocardial damage, the cardiac troponins. One barrier to the universal acceptance of these markers has been the observation that troponin T (cTnT) concentration is commonly increased in the presence of renal failure. Initially it was believed that this constituted an important false positive limitation of the test. This was confounded by problems with the initial cTnT assay and by the observation that troponin I (cTnI) was generally not increased in these patients. However, it has recently been demonstrated that the prognostic signi cance of a raised cTnT concentration in patients with a suspected ACS is unaffected by renal impairment. Further, powerful outcome studies are now being reported demonstrating that raised concentrations of serum cTnT are predictive of mortality in haemodialysis patients. This review summarizes our current understanding of the prevalence and signi cance of raised serum cTnT concentrations in patients with kidney disease and highlights areas where our understanding is incomplete. Evidence suggests that raised troponin concentrations in uraemic patients do indeed re ect myocardial injury. In the future, patients demonstrating this abnormality may be the target for more aggressive cardiac intervention, the advantages of which have been demonstrated in the non-uraemic population.

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“…1,2 Following damage to myocytes (e.g. due to myocardial infarction), cTnT and cTnI are released into the circulation.…”

Section: Introductionmentioning

confidence: 99%

The significance of serum troponin T in patients with kidney disease: a review of the literature

2004

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“…In this case, increased troponin levels can be found in the plasma for up to 21 days (Collinson, 2001). …”

Section: Discussionmentioning

confidence: 88%

“…The troponin molecules are eliminated from the blood by the kidneys (Collinson, 2001). The estimated half-life of troponin T in the circulation is 120 minutes, while that of troponin I is yet unknown (Katus, 1991;Wallace et al, 2004).…”

Section: Discussionmentioning

confidence: 99%

Short-term increase of serum troponin I and serum heart-type fatty acid-binding protein (H-FABP) in dogs following administration of formoterol

Strauss¹,

Wöhrmann²,

Frank³

et al. 2010

Experimental and Toxicologic Pathology

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et al.. Short-term increase of serum troponin I and serum heart-type fatty acid-binding protein (H-FABP) in dogs following administration of formoterol. Experimental and Toxicologic Pathology, Elsevier, 2010, 62 (4) This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting galley proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. A c c e p t e d m a n u s c r i p t -2 - AbstractIn this paper, changes in serum levels of the cardiac biomarkers troponin I and the heart-type fatty acid-binding protein (H-FABP) following administration of a longacting ȕ 2 -sympathicomimeticum (LABA = long-acting beta-agonist) to dogs were measured.We measured troponin I in dogs in a four week repeated-dose study with inhalative administration of formoterol (13 μg/kg/d) and a glucocorticoid/formoterol combination (143/16 μg/kg/d). The medians of troponin I increased within three days in both groups, far beyond the cut-off level (0.1 μg/L), but returned to baseline levels on study day 9. The increase was more pronounced in the formoterol-only group (3.29 μg/L) compared to the glucocorticoid/formoterol combination group (1.32 μg/L).In a second study, we measured serum troponin I as well as serum H-FABP levels in several samples over seven days in dogs, receiving a single inhalative dose of a glucocorticoid/formoterol combination (120/12 μg/kg/d). The median of the troponin I concentration increased above the cut-off level within two hours, that of H-FABP within four hours. The medians of both parameters were temporarily above the cut-off levels even on study day 7.Both studies were conducted according to national animal welfare guidelines.To our knowledge, this is the first report which shows a corresponding increase of troponin I and H-FABP in dogs treated with formoterol. Both parameters are more sensitive to detect a drug-induced cardiac injury compared to total LDH, total CK as well as CK MB activity. However, it is recommended to take at least three blood samples per day to assess a temporary increase of troponin I.A c c e p t e d m a n u s c r i p t -3 -

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“…For both cTnT and cTnI, several generations of assay have existed and have been comprehensively reviewed (Collinson et al 2001a). The measurement technology utilising electrochemiliuminesence for cTnT is supplied by one manufacturer (Roche Diagnostics) due to patent restrictions on the antibodies selected for the assay.…”

Section: Cardiac Troponinsmentioning

confidence: 99%

Cardiovascular Biomarkers for the Detection of Cardiovascular Disease

Gaze¹

2012

Coronary Artery Disease - Current Concepts in Epidemiology, Pathophysiology, Diagnostics and Treatment

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Measurement of cardiac troponins

Cited by 102 publications

References 19 publications

The significance of serum troponin T in patients with kidney disease: a review of the literature

The significance of serum troponin T in patients with kidney disease: a review of the literature

Short-term increase of serum troponin I and serum heart-type fatty acid-binding protein (H-FABP) in dogs following administration of formoterol

Cardiovascular Biomarkers for the Detection of Cardiovascular Disease

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