Title:Diagnostic Role and Methods of Detection of Cardiac Troponins: An Opinion
from Historical and Current Points of View
Volume: 19
Issue: 1
Author(s): Aleksey Michailovich Chaulin*
Affiliation:
- Department of Cardiology and Cardiovascular surgery, Medical faculty, Samara State Medical University, Samara,
Russia
- Department of Clinical Chemistry, Samara Regional Clinical Cardiological Dispensary, Samara, Russia
Keywords:
Cardiac troponins, troponin T, troponin I, biochemistry, analytical properties, high-sensitive immunological tests, 99th percentile, acute myocardial infarction, diagnosis.
Abstract: The laboratory methods for the determination of cardiac troponins (cTnI, cTnT) used
nowadays are extremely diverse, which has a significant impact on our understanding of the biology
and diagnostic the value of cTnI and cTnT as biomarkers. The main classification of methods
for the determination of cTnI and cTnT is based on the sensitivity of the immunoassay. Low- and
moderately sensitive detection methods are known to be relatively less sensitive, which leads to a
relatively late confirmation of cardiomyocyte death. Due to the new highly sensitive methods used
to determine cTnI and cTnT, designated as a highly or ultrasensitive immunoassays (hs-TnT and
hs-TnT), we received new, revised data about the biology of cardiac troponin molecules. In particular,
it became clear that they can be considered products of normal myocardium metabolism since
hs-TnT and hs-TnT are detected in almost all healthy patients. It also turned out that hs-TnT and
hs-TnT differ by gender (in men, troponin concentration in the blood is higher than in women), age
(in elderly patients, the levels of troponins are higher than in young ones) and circadian cycles
(morning concentrations of troponins are higher than in the evening). A large variety of methods
for determining cTnI and cTnT, differing in their diagnostic capabilities, creates the need for tests
to perform an unbiased assessment of the analytical characteristics of each method. This review focuses
on the most pressing issues related to the discussion of the biological characteristics of cardiac
troponin and the analytical characteristics of troponin immunoassays from a historical and contemporary
point of view.
