EDITORIAL

Are troponins confusing?

P O Collinson¹, P J Stubbs²

¹ Department of Chemical Pathology, St George’s Hospital, London, UK
² Department of Cardiology, Mayday Hospital, Croydon, Surrey, UK

Correspondence to:
Correspondence to:
Dr P O Collinson
Department of Chemical Pathology, St George’s Hospital, London SW17 0QT, UK; paul.collinson@stgeorges.nhs.uk

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The cardiospecificity and sensitivity of cardiac troponin measurement has proved to be a two edged sword for the laboratory and the clinician

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Keywords: cardiac troponin T; cardiac troponin I; myocardial infarction; acute coronary syndromes

Abbreviations: ACC, American College of Cardiology, ACS, acute coronary syndromes; AMI, acute myocardial infarction; CK, creatine kinase; cTnI, cardiac troponin I; cTnT, cardiac troponin T; ESC, European Society of Cardiology; NICI, non-ischaemic cardiac injury; NSTEMI, non-ST elevation myocardial infarction; PICI, primary ischaemic cardiac injury; SICI, secondary cardiac ischaemic injury

The first 150 words of the full text of this article appear below.

The ability to measure the cardiac specific markers, cardiac troponin T (cTnT) and cardiac troponin I (cTnI) (the cardiac troponins), has produced a paradigm shift in the assessment of patients with suspected acute coronary syndromes (ACS). Elevations of creatine kinase (CK) and its MB isoenzyme (CK-MB) resulting from skeletal muscle damage can now reliably be distinguished from those caused by acute myocardial infarction (AMI).¹ In the ACS patient, measurement of cTnT and cTnI identified prognostically significant myocardial damage when myocardial infarction was excluded by conventional tests.² This confirmed and extended previous work showing that minor but non-diagnostic elevations of CK-MB in ACS patients indicated myocardial damage and were prognostic.³ The evidence that cTnT and cTnI elevations predict prognosis in patients with and without ST elevation ACS is comprehensive and led to the proposed redefinition of AMI.⁴ This recognised cTnT and cTnI measurement as the biochemical diagnostic "gold standard". The role . . . [Full text of this article]

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