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Troponin T concentrations 72 hours after myocardial infarction as a serological estimate of infarct size
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  1. M Licka1,
  2. R Zimmermann3,
  3. J Zehelein1,
  4. T J Dengler1,
  5. H A Katus2,
  6. W Kübler1
  1. 1Department of Cardiology, University of Heidelberg, Heidelberg, Germany
  2. 2Department of Cardiology, University of Lübeck, Lübeck, Germany
  3. 3Städtisches Klinikum Pforzheim, Pforzheim, Germany
  1. Correspondence to:
    Prof Dr Rainer Zimmerman, Städtisches Klinikum Pforzheim, Kanzlerstrasse 2-6, 75175 Pforzheim, Germany;
    rainer_zimmermann{at}stadt-pforzheim.de

Abstract

Background: After acute myocardial infarction, the structural protein T is released considerably longer than cytosolic creatine kinase (CK), CK MB isoenzyme (CK-MB), or lactate dehydrogenase (LDH) and late troponin T release (> 48 hours after onset of chest pain) appears to be less affected by early coronary reperfusion.

Objective: To investigate the precision of a single measurement of circulating troponin T concentrations 72 hours after onset of chest pain compared with standard scintigraphic and enzymatic estimates of myocardial infarct size.

Methods: Quantitative single photon emission computed tomography thallium-201 scintigraphy at rest was performed in 37 patients 2–3 weeks after myocardial infarction (group 1: 14 patients without early coronary reperfusion; group 2: 23 patients with early reperfusion achieved by thrombolytic therapy, by percutaneous transluminal coronary angioplasty, or by both).

Results: In both groups, the number of myocardial segments with abnormal thallium-201 uptake indicating the individual extent of irreversible myocardial damage correlated significantly with the troponin T concentrations 72 hours after infarction as well as with peak concentrations of CK, CK-MB, and LDH.

Conclusion: The data show that a single measurement of circulating troponin T 72 hours after onset of chest pain—independent of reperfusion—is superior for the estimation of myocardial infarct size to measurement of peak CK, CK-MB, or LDH, which require serial determinations and depend on coronary reperfusion.

  • acute myocardial infarction
  • infarct size
  • troponin T
  • creatine kinase
  • thallium-201 scintigraphy
  • CK, creatine kinase
  • CK-MB, creatine kinase MB isoenzyme
  • ELISA, enzyme linked immunosorbent assay
  • LDH, lactate dehydrogenase
  • SPECT, single photon emission computed tomography
  • TnT, troponin T

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