Comparison of cardiac troponin T and I in healthy men and in aortic valve replacement

AbstractTroponins are of outstanding importance for the diagnosis of myocardial infarction. Cardiac troponin T (cTnT) and the various cardiac troponin I (cTnI) assays differ with respect to method comparison, diagnostic sensitivity and diagnostic specificity. To understand the differences in the diagnostic behavior of troponin assays, AccuTnI and Elecsys Troponin STAT were used in a group of healthy men and in the follow-up of patients with aortic valve replacement (AVR). Within the healthy subjects AccuTnI was able to differentiate two subgroups from each other, whereas the cTnT concentrations of all subjects were below the detection limit. In AVR patients, cTnT and cTnI correlated sufficiently, if the postoperative periods were taken into consideration. There was a rapid increase in cTnI within 24 h. In contrast, a broad peak was evident for cTnT between 48 and 120 h. The results emphasize more the differences in the release of cTnI and cTnT from the cytoplasm and the thin filaments of the cardiomyocytes than the modifications of the troponins circulating in the blood.

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Impact of high‐sensitivity cardiac troponin T on survival and rehospitalization after transcatheter aortic valve replacement

Catheterization and Cardiovascular Interventions ◽

10.1002/ccd.29781 ◽

2021 ◽

Author(s):

Simon Schoechlin ◽

Undine Schulz ◽

Philip Ruile ◽

Manuel Hein ◽

Martin Eichenlaub ◽

...

Keyword(s):

Aortic Valve ◽

Aortic Valve Replacement ◽

Valve Replacement ◽

Cardiac Troponin ◽

Transcatheter Aortic Valve Replacement ◽

Troponin T ◽

High Sensitivity ◽

Cardiac Troponin T ◽

Transcatheter Aortic Valve

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Prognostic Implications of Pre-Procedural High-Sensitivity Cardiac Troponin T in Patients Undergoing Transcatheter Aortic Valve Replacement

JACC Cardiovascular Interventions ◽

10.1016/j.jcin.2017.09.020 ◽

2017 ◽

Vol 10 (22) ◽

pp. 2345-2346 ◽

Cited By ~ 5

Author(s):

Markus Kofler ◽

Sebastian J. Reinstadler ◽

Lukas Stastny ◽

Julia Dumfarth ◽

Martin Reindl ◽

...

Keyword(s):

Aortic Valve ◽

Aortic Valve Replacement ◽

Valve Replacement ◽

Cardiac Troponin ◽

Transcatheter Aortic Valve Replacement ◽

Troponin T ◽

High Sensitivity ◽

Cardiac Troponin T ◽

Transcatheter Aortic Valve ◽

Prognostic Implications

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1461-P: Cardiac Troponin T and Troponin I and Incident Diabetes in the General Population: Generation Scotland Scottish Family Health Study

Diabetes ◽

10.2337/db19-1461-p ◽

2019 ◽

Vol 68 (Supplement 1) ◽

pp. 1461-P

Author(s):

PAUL WELSH ◽

DAVID PREISS ◽

ARCHIE CAMPBELL ◽

DAVID J. PORTEOUS ◽

NICHOLAS L. MILLS ◽

...

Keyword(s):

General Population ◽

Cardiac Troponin ◽

Troponin I ◽

Troponin T ◽

Family Health ◽

Incident Diabetes ◽

Health Study ◽

Cardiac Troponin T ◽

Generation Scotland

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Abstract 19134: Elevated Troponin T is Associated with Adverse Outcomes After Aortic Valve Replacement

Circulation ◽

10.1161/circ.130.suppl_2.19134 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Ashwat Dhillon ◽

Kanhaiya Poddar ◽

Murat Tuzcu ◽

Eric Roselli ◽

Lars Svensson ◽

...

Keyword(s):

Aortic Valve ◽

Aortic Valve Replacement ◽

Valve Replacement ◽

Troponin T ◽

Coronary Revascularization ◽

Care Center ◽

Tertiary Care ◽

Adverse Outcomes ◽

Post Procedure

Background: Data regarding association of elevated cardiac enzymes and adverse outcomes in patients who undergo aortic valve replacement (AVR) has been inconclusive. Role of coronary revascularization prior to AVR remains uncertain. We sought to understand prognostic implication of post procedure troponin T (TnT) elevation in patients undergoing AVR. Hypothesis: We hypothesized that patients with significantly elevated TnT after AVR will have worse outcomes representing important coronary circulation which is not revascularized. Methods: We retrospectively studied 4648 consecutive patients who underwent AVR at a single tertiary care center between January 2007 and December 2013. These were divided into surgical AVR (SAVR) and transcatheter AVR (TAVR). Median post procedure peak TnT was identified in the SAVR and TAVR groups. Patients were divided into quartiles based on median TnT level. Results: Of 4648 patients who underwent AVR, 4200 (66% male) were SAVR and 448 (59% male) were TAVR. Median post procedure peak TnT values in the TAVR and SAVR group were 0.19 [0.08-0.39] & 0.36 [0.22-0.64] respectively (p<0.001). 6 month mortality was 1.5% (65/4200) in SAVR cases and 2.7% (12/448) in TAVR cases (p=0.08). In patients with TnT less than 50 th percentile, 6 month mortality was 0.7% & 1.8% after SAVR & TAVR respectively (p=0.1). In patients with TnT higher than 50 th percentile, 6 month mortality was 2.4% & 3.6% after SAVR & TAVR respectively (p=0.26). In the SAVR group, mortality was 0.7% in patients with TnT levels less than 50 th percentile & 2.4% in patients with TnT higher than 50 th percentile (p<0.001). See Figure. Conclusion: Peak troponin T was significantly higher after SAVR as compared to TAVR. Higher post procedure peak TnT is associated with increased 6 month mortality. These results are highly significant in the SAVR group. The mechanism and significance of these findings requires further studies.

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Cardiac Troponin Complex: Cardiac Troponin C (TNNC1), Cardiac Troponin I (TNNI3), and Cardiac Troponin T (TNNT2)

Encyclopedia of Signaling Molecules ◽

10.1007/978-1-4614-6438-9_101901-1 ◽

2016 ◽

pp. 1-10

Author(s):

Zabed Mahmud ◽

Peter M. Hwang

Keyword(s):

Cardiac Troponin ◽

Troponin I ◽

Troponin T ◽

Troponin C ◽

Cardiac Troponin I ◽

Cardiac Troponin T ◽

Cardiac Troponin C ◽

Troponin Complex

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Biological variation of cardiac troponins in chronic kidney disease

Annals of Clinical Biochemistry International Journal of Laboratory Medicine ◽

10.1177/0004563220906431 ◽

2020 ◽

Vol 57 (2) ◽

pp. 162-169

Author(s):

RA Jones ◽

J Barratt ◽

EA Brettell ◽

P Cockwell ◽

RN Dalton ◽

...

Keyword(s):

Myocardial Infarction ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Cardiac Troponin ◽

Troponin I ◽

Troponin T ◽

Biological Variation ◽

Cardiac Troponin I ◽

Cardiac Troponin T ◽

Reference Change Value

Background Patients with chronic kidney disease often have increased plasma cardiac troponin concentration in the absence of myocardial infarction. Incidence of myocardial infarction is high in this population, and diagnosis, particularly of non ST-segment elevation myocardial infarction (NSTEMI), is challenging. Knowledge of biological variation aids understanding of serial cardiac troponin measurements and could improve interpretation in clinical practice. The National Academy of Clinical Biochemistry (NACB) recommended the use of a 20% reference change value in patients with kidney failure. The aim of this study was to calculate the biological variation of cardiac troponin I and cardiac troponin T in patients with moderate chronic kidney disease (glomerular filtration rate [GFR] 30–59 mL/min/1.73 m2). Methods and results Plasma samples were obtained from 20 patients (median GFR 43.0 mL/min/1.73 m2) once a week for four consecutive weeks. Cardiac troponin I (Abbott ARCHITECT® i2000SR, median 4.3 ng/L, upper 99th percentile of reference population 26.2 ng/L) and cardiac troponin T (Roche Cobas® e601, median 11.8 ng/L, upper 99th percentile of reference population 14 ng/L) were measured in duplicate using high-sensitivity assays. After outlier removal and log transformation, 18 patients’ data were subject to ANOVA, and within-subject (CVI), between-subject (CVG) and analytical (CVA) variation calculated. Variation for cardiac troponin I was 15.0%, 105.6%, 8.3%, respectively, and for cardiac troponin T 7.4%, 78.4%, 3.1%, respectively. Reference change values for increasing and decreasing troponin concentrations were +60%/–38% for cardiac troponin I and +25%/–20% for cardiac troponin T. Conclusions The observed reference change value for cardiac troponin T is broadly compatible with the NACB recommendation, but for cardiac troponin I, larger changes are required to define significant change. The incorporation of separate RCVs for cardiac troponin I and cardiac troponin T, and separate RCVs for rising and falling concentrations of cardiac troponin, should be considered when developing guidance for interpretation of sequential cardiac troponin measurements.

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