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Troponin (Tn, TnI, TnT)

Last updated 20.09.12

 

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Index

 

Definition

-  Cardiac enzyme used as indicator of cardiac muscle damage

 

Features

-  Contractile protein found in skeletal & cardiac muscle

-  Most sensitive & specific marker for  AMI 

-  Preferred biomarker for AMI 

-  Troponin I (TnI) less often used

-  Troponin T (TnT)

-  New high sensitivity assays

-  Increased sens

-  93% at 30min

-  98% at 2hrs

-  100% at 3hrs

-  Decreased specificity

-  57% at 2hrs

-  54% at 3hrs

 

Indication

-  Ix of Chest pain

-  Dx AMI, DDx angina

-  Rise 3-4 hrs post AMI 

-  Peak 18-36 hrs

-  Persist for 10-14 days

 

Results

-  False positives in context of

-  AF, CRF, ARF or CPR

-  Valve disease

-  Cardiomyopathy

-  Drug toxicity

-  PE

-  Normal <0.05

-  Angina

-  Elevation

-  AMI 

-  Severe tachycardia: SVT, AF w rapid vent rate

-  Myocarditis, pericarditis

-  Cardiomyopathy

-  Sepsis

-  COPD, PE

-  SAH, stroke, epilepsy