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Troponin I and Troponin T
Troponin I and Troponin T
Cardiac Troponins
advantages
o Troponin I
o troponin T and I are present for, and remain elevated, a long time
unlike CK and CK-MB, cTnT and cTnI are released for much
longer with cTnI detectable in the blood for up to 5 days and
cTnT for 7-10 days following MI. This allows an MI to be
detected if the patient presents late. For example, if a patient
comes to the surgery with a history of chest pain 2-3 days ago,
measurement of cTnT or cTnI will allow the diagnosis or
exclusion of MI as a cause of the chest pain
o failure to show a rise in cTnT or cTnI does not exclude the diagnosis of
ischaemic heart disease
o both cTnT and cTnI may be elevated in patients with chronic renal
failure and indicate a higher long-term risk of death. They can be
distinguished from changes due to myocardial infarction by repeating
the tests. Myocardial infarction causes a rise and fall in cTnT or cTnI,
but in renal failure the elevated levels are sustained
Reference:
Source
Institute of Cardiology, Kaunas University of Medicine, Sukileliu 17, 50157 Kaunas, Lithuania.
dovilek@yahoo.com
Abstract
In this article we investigate clinical specificity and sensitivity of cardiac troponin T and
cardiac troponin I tests in the patients who were admitted to the hospital with suspected
acute coronary syndrome. We investigated 87 patients: the clinical investigation was
performed, electrocardiogram was recorded and concentrations of cardiac troponin T
and troponin I were estimated. According to the recommendations of the manufacturers
of troponin T and troponin I tests, threshold diagnostic troponin T concentration for
myocardial infarction was considered > or =0.1 ng/ml and troponin I > or =1.0 ng/ml.
Troponin T concentration was analyzed in 60 patients; the sensitivity of troponin T test in
diagnosing acute myocardial infarction was 85%, and the specificity was 87.2%.
Troponin I test was performed in 46 patients; the sensitivity of the test was 76% and the
specificity was 76.2%. In case when both troponin T and I tests were performed, the
sensitivity of troponin T was 100% and specificity was 78% and of troponin I -
respectively 86% and 78%. According to the receiver operator characteristic analysis
there was no significant difference between the general accuracy of troponin T and
troponin I in distinguishing patients with and without acute myocardial infarction.
According to the results of receiver operator characteristic analysis, the biggest clinical
sensitivity and specificity were achieved when threshold myocardial infraction diagnostic
concentration of troponin T was considered >0.04 ng/ml and of troponin I >0.69 ng/ml.