Cardiac troponin I (TnI) and T (TnT): Interpretation and evaluation in acute coronary syndromes

Cardiac troponin I (TnI) and T (TnT): Interpretation and evaluation in acute coronary syndromes

Troponin is a protein complex expressed in cardiac and skeletal muscle. The complex consists of troponin I (TnI) , troponin C (TnC) and troponin T (TnT) , which enable the interaction between actin and myosin and are therefore fundamental to muscle contraction. There are cardiac-specific isoforms of troponin and these are abbreviated cTnI, cTnT, and cTnC. The isoforms cTnI and cTnT are specific to cardiac muscle cells. Cardiac troponin levels are extremely low in healthy subjects; the 99 th percentile is less than a few nanograms per liter of blood (typically <5 ng/L). This is explained by the low turnover of cardiac muscle cells ( Parmacek et al ). Cardiac troponin levels rise within a few hours after the onset of myocardial infarction. This is utilized in clinical practice by detecting troponins in patients with suspected acute coronary syndromes. Several manufacturers have developed highly sensitive troponin assays for troponin I (cTnI) and troponin T (cTNT). The following differences exi…

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