Cardiac troponins as an evidence of myocardial necrosis but not always the marker of myocardial infarction
Journal Title: Postępy Nauk Medycznych - Year 2010, Vol 23, Issue 12
Abstract
Cardiac troponins (cTn) are regulatory proteins that control the calcium-mediated interaction of actin and myosin. The troponin complex consists of 3 subunits: troponin I (cTnI), troponin T (cTnT) and troponin C (cTnC). The specificity of cardiac isoforms is the basis for clinical utility of cTnI and cTnT assays. Very small amounts of myocardial necrosis (< 1g) be detected by the latest generation of sensitive troponins. The ESC/ACC recommended that diagnosis of myocardial infarction (MI) should be based on troponin level above of the 99th percentile of a reference control group with a coefficient of variation of 10 percent or less, when there is an evidence of myocardial necrosis in a clinical setting consistent with myocardial ischemia. Cardiac troponins are useful and preferred cardiac biomarker of necrosis for diagnosis and risk assessment in patients with suspected acute coronary syndromes (ACS). In the group of patients with stable coronary artery disease (CAD) the elevated cTnT level are significantly associated with the incidence of cardiovascular death and heart failure. Cardiac troponins can also be detected in a variety of other diseases, such as heart failure, pulmonary embolism, hypovolemia, atrial fibrillation, myocarditis, sepsis, renal failure, myocardial contusion, critical illness and during endurance exercise. The release of cTn in such situations is subsequent to imbalance between myocardial oxygen demand and supply. Neither functional changes (evaluated by cardiovascular magnetic resonance) nor myocardial inflammation or fibrosis were connected with post endurance release of cTn.
Authors and Affiliations
Piotr Kokowicz
Keywords
Related Articles
- EP ID EP53824
- DOI -
- Views 214
- Downloads 0
Prophylaxis and treatment of hyperhomocysteinemia
Homocysteine (Hcys) is a non-protein sulfur-containing amino acid, an intermediate product of methionine metabolism. It is known that elevated concentration of homocysteine (> 15 µM; hyperhomocysteinemia) in human...
Resekcja gruczolakoraka przełyku i wpustu techniką przezrozworową z użyciem toru wizyjnego laparoskopu
Wstęp. Niski odsetek 5-letniego przeżycia chorych na raka gruczołowego przełyku i wpustu jest przyczyną poszukiwania optymalnych technik jego leczenia. Jedną z nich jest przezrozworowa resekcja przełyku przy użyciu toru...
Diversion colitis – pytania i dylematy. Aktualny stan wiedzy i własne doświadczenia
Invasive fungal infections in children and adolescents after hematopoietic stem cell transplantation
Introduction. Infections are the main cause of morbidity and mortality in children with cancer or undergoing stem cell transplantation. Patients undergoing hematopoietic stem cell transplantation (HSCT) are at particular...
Wyniki leczenia nietrzymania moczu z użyciem sztucznego zwieracza cewki moczowej
<b>Wstęp. </b>Jednym z uznanych sposobów leczenia nietrzymania moczu (NTM) będącego następstwem braku czynności zwieracza zewnętrznego cewki moczowej jest implantacja sztucznego zwieracza cewk...